The Department of Justice unveiled charges against 455 people, including 90 doctors and other licensed medical professionals, for their alleged participation in healthcare schemes that involved more than $6.5 billion in false claims and other patient harm.
The charges were part of a two-week coordinated fraud takedown headed by the DOJ Criminal Division’s Health Care Strike Force program, but reflects “a whole-of-government approach” that involved the Centers for Medicare and Medicaid Services as well as international partners, law enforcement said in a press release issued Tuesday.
Of note, the enforcement included a record 295 charged defendants and more than $518 million of false claims related to Medicaid, a new record for the unit’s takedowns and a continuation of the Trump administration’s focus on bad actors within the program.
“We are aggressively scaling our offensive against anyone using health care as a front to steal from the American people,” Assistant Attorney General Colin M. McDonald, of the Justice Department’s National Fraud Enforcement Division, said in the announcement. “As today’s cases and arrests show, there is no case too big, no scheme too complex, and no hiding place too remote for our relentless fraud-fighting team. Our message is simple: if you put profit over patients, you should expect to be put in prison.”
Included among the totals are more than $73 million across 48 civil monetary payment settlements, civil charges against 13 defendants for $14.8 million in health care fraud schemes and civil settlements with 31 defendants totaling $23 million. CMS also suspended 1,079 providers and revoked billing privileges for 1,403 providers, while the Department of Health and Human Services Office of Inspector General (HHS-OIG) initiated actions to restore over $10 billion of flagged and suspended payments back to the Medicare Trust Fund.
DOJ also noted it had seized over $182 million in cash, luxury vehicles, jewelry and other assets. Defendants, DOJ said, covered the “full-spectrum … from doctor’s offices to corporate boardrooms,” and included apprehensions of individuals from overseas, including a FBI Most Wanted who was tied to a previously-charged $1.2 billion telemedicine fraud scheme.
Highlighted among the enforcement actions were charges against 11 defendants in connection with fraudulent amniotic wound allografts. One company was allegedly responsible for more than $4 billion of Medicare billings and $2 billion of payments for amniotic wound allografts. Another charged defendant, a nurse practitioner, allegedly was involved in a $906 million scheme that billed Medicare more than $1 million per patient on average for unneeded allografts, while three others were charged in a similar $118 million fraud scheme.
DOJ said the prosecutions stem from a payment spike for allografts spotted by the Health Care Fraud Unit’s Data Analytics Team. It also noted CMS’ separate move to reduce payment for the service at the top of this year, which together has led to 2025’s $14.4 billion of Medicare claims for allografts to plummet to $100 million since the start of this year.
“Prosecuting criminals who steal from American patients is necessary—but stopping them before a single dollar leaves the building is smarter,” CMS Administrator Mehmet Oz, M.D., said in the DOJ’s release. “CMS is done playing catch-up. We’re deploying advanced data analytics to expose fraud networks, freeze suspicious payments, and shut down bad actors before they can do damage to the programs that millions of Americans depend on.”
Within the realm of Medicaid fraud, the DOJ underscored charges against eight defendants in New York for their roles in a $38 million scheme related to medically unnecessary social adult day care services. Also flagged was a $49 million Virginia fraud scheme in which homeless individuals were given hotel stays in exchange for fraudulent crisis stabilization service billings, and an Arizona scheme for unprovided behavioral services “primarily targeting Native Americans struggling with substance abuse,” DOJ said.
Included as part of the takedown were several cases that leaned on the Health Care Fraud Unit’s recently launched Data Fusion Center, which combines experts from multiple agencies and uses advanced analytics. Among these was the first prosecution for the center’s Financial Intelligence Review Team: a $67 million scheme billing Illinois Medicaid for behavioral services that weren’t provided.
DOJ’s announcement also outlined 36 defendants charged in connection with the alleged illegal diversion of controlled substances, including prescription opioids, that led to patient harm, and a charge against the medical director of a cardiovascular testing and treatment practice whose alleged $89 million scheme rubber-stamping test results for student athletes missed an enlarged heart and led to a student athlete’s death.
The takedown’s cases were filed in 56 federal districts and 45 different U.S. states and territories, with the DOJ also noting a new department record of participation from all 50 state Medicaid Fraud Control Units. The $6.5 billion in false claims is among the larger tallies logged in such a takedown, with last year’s $14.6 billion effort currently holding the crown.
The DOJ’s Health Care Fraud Strike Force was formed in 2007 and, prior to Tuesday’s takedown announcement, had collectively charged over 6,200 defendants tied to more than $45 billion of fraudulent billing.