Key facts
- The Department of Justice charged over 450 defendants for alleged healthcare fraud totaling more than $6.5 billion.
- This operation is the second-largest healthcare fraud takedown in history.
- The charges include the largest number of Medicaid fraud defendants and losses ever recorded by the DOJ.
- Schemes involved wound care, hospice, adult day care, opioid distribution, and fraudulent skin substitute claims.
- Cases spanned 56 federal districts across 45 U.S. states and territories.
The Department of Justice announced on Tuesday that it has charged more than 450 individuals and entities in connection with healthcare fraud schemes totaling over $6.5 billion. This coordinated enforcement action, described as the department's largest to date, spans 56 federal districts across 45 U.S. states and territories.
Officials highlighted that this operation represents the second-largest amount ever charged in a healthcare fraud takedown. The charges target a range of alleged schemes, including wound care, hospice services, adult day care, and the illegal distribution of opioids. Notably, the enforcement actions also included the largest number of Medicaid fraud defendants and the largest amount of Medicaid fraud loss ever charged by the department, with 295 defendants and over $518 million in false claims.
Health Secretary Robert F. Kennedy Jr. expressed concern over the allegations, stating that some defendants are accused of ordering medically unnecessary tests, prescribing unneeded products, fueling opioid addiction for revenue, and in some cases, leading to patient deaths. The DOJ emphasized unprecedented cooperation from states in bringing these cases.
Acting Attorney General Todd Blanche issued a strong warning to fraudsters, vowing to find, seize assets from, and prosecute those who seek to cheat Americans. The DOJ detailed specific cases, including charges against 11 defendants for billions in fraudulent claims for skin substitutes. One executive allegedly orchestrated a kickback scheme, relabeling allografts and selling them at a 2,000 percent markup, paying illegal kickbacks that allowed providers to profit significantly. This executive allegedly used over $24 million in proceeds for luxury purchases.
In another instance, a nurse practitioner in Texas was charged for billing Medicare over $1 million per patient on average for skin substitutes, using the illicit gains to fund luxury vehicles, jewelry, a home in Hawaii, and a beach resort in the Philippines.