A 50-district dragnet uncovers transnational fraud, AI-driven deception, and systemic theft from Medicare, Medicaid, and U.S. taxpayers totaling over $14.6 billion
The Department of Justice announced Monday the outcome of the 2025 National Health Care Fraud Takedown, the largest coordinated enforcement action against health care fraud in U.S. history. Federal prosecutors have filed criminal charges against 324 individuals across 50 federal judicial districts and 12 State Attorneys General’s Offices, including 96 licensed medical professionals—among them doctors, nurse practitioners, and pharmacists. The defendants stand accused of orchestrating fraudulent schemes amounting to more than $14.6 billion in intended losses to Medicare, Medicaid, and other federally funded programs.
This historic enforcement action more than doubles the previous national record of $6 billion. As part of this effort, federal and state authorities have seized over $245 million in cash, luxury vehicles, cryptocurrency, and other high-value assets. The Centers for Medicare & Medicaid Services (CMS) separately reported that it successfully prevented more than $4 billion in fraudulent payments in the months leading up to the Takedown. CMS also confirmed that it suspended or revoked the billing privileges of 205 providers linked to fraudulent activity. In the civil domain, federal agencies filed actions against 20 defendants tied to $14.2 million in alleged fraud and finalized civil settlements with an additional 106 defendants, totaling $34.3 million in recovered funds.
The Takedown was led by the Health Care Fraud Unit of the DOJ Criminal Division’s Fraud Section and carried out in close coordination with U.S. Attorneys’ Offices nationwide, the Department of Health and Human Services Office of Inspector General (HHS-OIG), the Federal Bureau of Investigation (FBI), the Drug Enforcement Administration (DEA), and multiple state law enforcement agencies. Medicaid Fraud Control Units in 18 states also played a central role in investigating and prosecuting the cases.
In remarks accompanying the announcement, Secretary of Health and Human Services Robert F. Kennedy Jr. emphasized that the agency would aggressively work with law enforcement to eliminate the “pervasive health care fraud that drove up costs and harmed patients under the former administration.” Attorney General Pamela Bondi echoed the urgency, calling the action “justice delivered to those who steal from taxpayers and endanger lives.” Matthew R. Galeotti, head of the Justice Department’s Criminal Division, underscored the gravity of the crimes targeted, noting that fraudulent schemes often lead not only to financial losses but also to direct patient harm, including medically unnecessary procedures and worsened addiction outcomes.
FBI Director Kash Patel emphasized that this Takedown represents the largest in the bureau’s history, highlighting the theft of more than $13 billion from federal health programs. Acting Inspector General Juliet T. Hodgkins of HHS-OIG described the scale of harm as unprecedented and reaffirmed the agency’s commitment to safeguarding the public.
Among the most significant components of this national operation was Operation Gold Rush, which uncovered a sophisticated transnational conspiracy responsible for over $10 billion in fraudulent Medicare claims. The scheme was orchestrated by foreign nationals who, acting as a coordinated criminal enterprise, acquired more than 30 medical supply companies across the United States. These companies had already been enrolled in Medicare, and were then used to funnel false claims for urinary catheters and other durable medical equipment. Stolen identities of over one million Americans were used to submit these claims, which had not been requested by patients, nor ordered by physicians.
The conspiracy relied on straw owners sent from Russia and Estonia to the U.S., who were directed by co-conspirators communicating through encrypted channels. Using fraudulent documentation, these straw owners opened U.S. bank accounts for laundering proceeds. Though the organization submitted over $10.6 billion in claims, CMS successfully blocked most of the payments. Only approximately $41 million reached the conspirators via Medicare, but approximately $900 million was disbursed by Medicare supplemental insurers before the fraud was detected.
Four individuals were arrested in Estonia and eight others were apprehended at major U.S. airports and border crossings as they attempted to flee. Law enforcement seized approximately $27.7 million in fraud proceeds from this operation.
Federal prosecutors filed related charges in five districts: the Central District of California, the Middle District of Florida, the Northern District of Illinois, the District of New Jersey, and the Eastern District of New York.
In a separate scheme centered in Illinois, the Department brought charges against five individuals, including two executives from Pakistani marketing firms, who used artificial intelligence to generate fake audio recordings of Medicare beneficiaries purporting to consent to receive medical equipment. This fraudulent data was sold to laboratories and equipment suppliers, which used it to file $703 million in false claims. Approximately $418 million was ultimately paid out on these claims, and the government has so far seized $44.7 million in related assets. The fraud involved not only AI-based deception but also the illegal sale and laundering of stolen personal health information.
Another case exposed a billing company executive based in Pakistan and the United Arab Emirates who conspired with addiction treatment centers to submit approximately $650 million in fraudulent claims to Arizona Medicaid. Some services billed were never rendered, and others were so deficient as to provide no therapeutic value. The operation targeted vulnerable individuals, including members of Native American tribes and the homeless. Kickbacks were paid for patient referrals, and the executive used at least $25 million in illicit funds to purchase a $2.9 million home in Dubai.
The Department also charged 49 defendants in connection with over $1.17 billion in fraudulent claims tied to telemedicine and genetic testing. In one Florida case, an owner of both telemedicine and durable medical equipment companies orchestrated a $46 million scheme involving deceptive telemarketing campaigns that generated unauthorized genetic testing and equipment claims. The Department continues to prioritize cases involving telehealth-based fraud, which often exploits unwitting patients through misrepresented or manufactured consent.
Prescription opioid diversion was another central focus of the Takedown. A total of 74 defendants, including 44 licensed medical professionals, were charged across 58 criminal cases for illegally distributing more than 15 million opioid pills. One Texas pharmacy alone was responsible for over 3 million of these pills, which included highly addictive substances such as oxycodone, hydrocodone, and carisoprodol. The DEA concurrently announced 93 administrative actions to revoke licenses and registrations of pharmacies and providers implicated in the unlawful handling of controlled substances.
Other cases include a $28.7 million scheme in Tennessee involving medications falsely billed to the Federal Employees’ Compensation Fund, where prescriptions were neither authorized by physicians nor dispensed as claimed. In separate indictments filed in Washington and California, medical providers were charged with stealing fentanyl and hydrocodone intended for pediatric patients under anesthesia.
The geographic scope of the Takedown was vast. In total, 189 federal cases were filed across all 50 federal judicial districts, and 91 state-level cases were brought in 12 states by participating Attorneys General. This unprecedented coordination underscores the national impact and bipartisan support for rooting out fraud in American health care systems.
To enhance ongoing efforts, the Department also announced the establishment of a new Health Care Fraud Data Fusion Center.
This joint initiative brings together specialists from the DOJ’s Health Care Fraud Unit, HHS-OIG, FBI, and CMS to leverage cloud computing, artificial intelligence, and large-scale data analytics to detect emergent fraud patterns. The Fusion Center aligns with Executive Order 14243, “Stopping Waste, Fraud, and Abuse by Eliminating Information Silos,” which mandates interagency cooperation and data-sharing to reduce redundancy and increase efficiency in enforcement.
Principal Assistant Deputy Chief Jacob Foster, Assistant Deputy Chief Rebecca Yuan, Trial Attorney Miriam L. Glaser Dauermann, and Data Analyst Elizabeth Nolte coordinated this year’s Takedown from within the DOJ’s Health Care Fraud Unit. Prosecutors from the National Rapid Response team and regional Strike Forces in 27 districts led casework alongside U.S. Attorneys’ Offices and 18 state Medicaid Fraud Control Units. Additional support came from the Department of Labor, VA-OIG, IRS Criminal Investigation, Homeland Security Investigations, the Defense Criminal Investigative Service, the Office of Personnel Management, the United States Postal Service OIG, and numerous other federal and local agencies.
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Minister Gary Anandasangaree said his priorities are getting a new border bill passed and tackling illegal immigration.
Canada’s Public Safety Minister admitted that he has yet to meet with anyone from 123 Christian, mostly Catholic, churches that have been either reduced to ashes or seriously vandalized over the past four years.
Speaking recently before a committee to discuss upcoming fall bills, Minister Gary Anandasangaree was grilled by opposition Conservative MPs on a host of issues from public safety and illegal migrants to church arsons.
He said his priorities are getting a new border Bill C-12 passed while tackling illegal immigration but made no specific mention of tackling the rise of Christian hate in Canada.
Asked by Conservative MP Dane Lloyd about whether he met with any of the 123 and counting church congregations, he replied that he has not, but he claimed he has met with “many members of different church and faith groups.”
“You said you met with synagogues and mosques, which I do appreciate,” noted Lloyd, adding, “Those communities need your support, Minister, but Christian communities also need your support.”
“Why have you not met with any of those communities?” he asked.
Anandasangaree said he was “concerned (about) every incidence of hate at any place, including churches,” but stopped short of promising anything.
He was also asked about allegations that a government employee who works on a local military base near Montreal was the one responsible for throwing smoke bombs into a church service this summer.
Anandasangaree said he is “concerned” about these allegations but did not add any other context.
Canadian Conservative pro-life and pro-family MP Leslyn Lewis called out the hypocrisy of a new Liberal “hate” speech bill recently for being silent regarding rising “Christian hate,” because it does not even mention church arson.
Hate-motivated attacks against Christians are on the rise in Canada. In 2021 and 2022, the mainstream media ran with inflammatory and dubious claims that hundreds of children were buried and disregarded by Catholic priests and nuns who ran some Canadian residential schools. The reality is, after four years, there have been no mass graves discovered at residential schools.
However, as the claims went unfounded, since the spring of 2021, over 120 churches, most of them Catholic, many of them on indigenous lands that serve the local population, have been burned to the ground, vandalized, or defiled in Canada.
The Canadian media has been rather silent on the church burnings.
The government-funded Canadian Broadcasting Corporation (CBC) went as far as blaming the fact that it has not covered the arson attacks much on “staffing shortage.
Indeed, the absence of reports about church burnings was uncovered by former CRTC chair Peter Menzies, who could not find any information on the recent arson attack against All Saints Ukrainian Orthodox in Bellis, Alberta.
Two teenage boys in Florida are being called heroes for their response to a five-second TikTok video last month that may well have averted disaster all the way across the country.
The video, which has since been taken down, reportedly showed plans for a mass school shooting at Kamiakin High School in Kennewick, Wash.
“The contents of the TikTok were a map of a high school, and it had classrooms that were identified and labeled as targets,” said Kennewick School Board member Brittany Gledhill in a Thursday interview with The Center Square. “It had other classrooms that were labeled as potential targets. It had labeled exits, and it had the security department of the school listed as a potential threat.”
The map in the video did not indicate the location or name of the school.
“But this young man who lives in Florida decided to show it to a brother, and then together they decided that they needed to tell the authorities,” Gledhill said.
She explained that local authorities in Florida contacted the FBI, and within hours, the investigation was underway to determine the TikTok poster’s location.
That was September 19, a Friday.
“We got involved on Sunday, so that we were able to sweep the campus and provide a secure and safe environment for our students and staff, and that was in conjunction with KPD, or Kennewick police department,” said Kennewick School District Superintendent Lance Hansen.
At that point, the suspect, a 14-year-old Kamiakin High School freshman, was already in custody.
According to the Tri-City Herald, the FBI was able to match the layout and room numbers shown in the TikTok video to Kamiakin High School, and at that point, the FBI contacted the internet provider about the IP address linked to the account.
Officials were able to narrow down the location to a few dozen potential residences in Kennewick, and according to the Herald, law enforcement further narrowed the list based on the times the TikTok account was active.
The address was further narrowed to the boy’s home, where he reportedly lived with his grandparents, and more than two dozen firearms were located.
Hansen told The Center Square that officials believe the young man was most likely to carry out his plan had the boys in Florida not done the right thing.
“It was smart and courageous at the same time, and I think that they can be an example or model for others who may see something and think it’s not a big deal. Just the thought that they would recognize this isn’t right and have the courage to speak up … that’s really where I believe the story is,” Hansen said.
Gledhill said the school board, administration and staff members from Kamiakin High School are putting together a gift basket and thank-you notes for the boys in Florida who reported the TikTok post to authorities.
“We averted a terrible tragedy because of these two young men,” she said. “This is my home high school, and I have two of my own children [who] go to that school.”
Hansen said the school community is still reeling from what could have happened, but is also trying to find a lesson in it.
“In times where information can flow so quickly and there’s some level of anonymity that is created in ways that we communicate, like with social media, it sometimes creates some boldness in youth, which I think is a false positive,” he said. “I mean, there are benefits to the way that we communicate, and there [are] some unintended consequences of that. Having said that, as I reminded our parents, every person who’s on a campus is responsible for the safety of the campus. That’s students, staff, whoever is there. So that model … needs to be applied for everything.”
Given that the accused is 14, he is being charged as a juvenile. Assuming he pleads guilty or is convicted, he could only be confined until he turns 21.
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