DOJ announces 324 arrests in $14.6B healthcare fraud crackdown
The U.S. Department of Justice (DOJ) announced Monday that it has undertaken the largest healthcare fraud takedown in history, with 324 people charged in schemes that could have cost taxpayers $14.6 billion.
The previous record for a nationwide, single-day series of coordinated arrests for healthcare fraud was $6 billion, the agency said in a statement.
In detailing those who have been charged for various crimes, the list includes 96 doctors, nurse practitioners, pharmacists and other licensed medical professionals whose actions have allegedly cost the government $2.9 billion in losses to date.
As to what the defendants are accused of, the DOJ said that for the healthcare professionals, it’s mostly medical claims fraud, with bills submitted to Medicare and Medicaid that are either outright fraudulent or misrepresent the care delivered to patients.
However, prosecutors said 29 of those arrested were allegedly affiliated with “transnational criminal organizations,” with links to Estonia, Mexico and elsewhere. These individuals stand accused of submitting more than $12 billion in “fraudulent claims to America’s health insurance programs.”
In cooperation with federal police from multiple agencies, including the Federal Bureau of Investigation (FBI) and the Drug Enforcement Administration (DEA), the DOJ said investigators were able to block escape routes.
The DOJ elaborated, stating that one of the plots involved the use of assumed identities and encrypted messaging, with actors working for foreign entities illegally buying “dozens of medical supply companies” from across the country.
“This record-setting healthcare fraud takedown delivers justice to criminal actors who prey upon our most vulnerable citizens and steal from hardworking American taxpayers,” U.S. Attorney General Pamela Bondi said in a statement. “Make no mistake: This administration will not tolerate criminals who line their pockets with taxpayer dollars while endangering the health and safety of our communities.”
Defendants accused of various acts of fraud
Other uncovered schemes resulting in arrest were linked to bogus wound care provided to unwitting elderly patients, where taxpayers were allegedly bilked for $1.1 billion, with 74 arrests made in connection with those schemes.
Telehealth fraud was also part of the investigation, with 49 individuals charged for submitting claims for unnecessary genetic tests and medical equipment—including one highlighted example, where a Florida-based company allegedly used 'deceptive telemarketing campaigns' targeting Medicare beneficiaries for services that had no medical need.
Opioid trafficking was also part of the announcement, with dozens of medical professionals accused of illegally distributing controlled substances.
While charges have been filed in all of the above, defendants have not had their day in court and remain innocent until proven guilty. It remains to be seen what charges will stick and if the scope of the fraud incidents is as massive as prosecutors claim.
For case descriptions with names of the accused and additional info, click here.
Chad is an award-winning writer and editor with over 15 years of experience working in media. He has a decade-long professional background in healthcare, working as a writer and in public relations.