DOJ Announces Largest Ever Health Care Fraud Takedown
The U.S. Department of Justice has announced the results of its 2025 National Health Care Fraud Takedown, the largest in its history, eclipsing the previous record of $6 billion with actions to disrupt health care fraud schemes involving more than $14.6 billion in intended losses.
Criminal charges have been filed against 324 defendants, including 96 licensed healthcare professionals such as doctors, nurse practitioners, and pharmacists, in 50 federal districts. Across those actions, the government recovered approximately $245 million in cash, cryptocurrency, luxury vehicles, and other assets, while the CMS confirmed that more than $4 billion was prevented from being paid through fraudulent and false claims. In the months leading up to the arrests, the privileges of 205 providers were suspended or revoked.
The Health Care Fraud Unit of the Department of Justice Criminal Division’s Fraud Section led the takedown, with assistance provided by the Federal Bureau of Investigation (FBI), Drug Enforcement Agency (DEA), HHS Office of Inspector General (HHS-OIG), and other state and federal enforcement agencies. More than 50 U.S. attorneys’ offices and 12 state attorneys general’s offices have assisted with prosecuting the fraud cases.
“The scale of today’s Takedown is unprecedented, and so is the harm we’re confronting. Individuals who attempt to steal from the federal health care system and put vulnerable patients at risk will be held accountable,” said Acting Inspector General Juliet T. Hodgkins of HHS-OIG. “Our agents at HHS-OIG work relentlessly to detect, investigate, and dismantle these fraud schemes. We are proud to stand with our law enforcement partners in protecting taxpayer dollars and safeguarding patient care.”
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Among the individuals charged were 29 defendants for their roles in transnational criminal organizations that submitted more than $12 billion in claims to health insurance programs in the United States. They included individuals responsible for $10.6 billion in fraudulent health care claims to Medicare for urinary catheters and other durable medical equipment. Charges were filed against 19 defendants in connection with this fraud scheme, 12 of whom have been arrested, including four in Estonia and seven at airports and border crossings while attempting to flee the United States.
While many transnational criminal organizations have attempted to defraud U.S. healthcare programs, U.S. fraudsters have also been highly active. In one such case, charges were filed against seven defendants, including five doctors, for their role in a scheme that saw around $1.1 billion charged to Medicare and other healthcare programs for medically unnecessary amniotic wound allografts. Some of the defendants received millions in illegal kickbacks.
The takedown also included charges being filed against 74 defendants across 58 cases involving prescription opioid trafficking, 49 defendants were charged in connection with $1.17 billion in allegedly fraudulent claims to Medicare related to telemedicine and genetic testing fraud schemes, and 170 defendants were involved in other fraud schemes involving medically unnecessary diagnostic testing, medical visits, and treatments totaling more than $1.84 billion.
