The largest healthcare fraud bust in U.S. history has exposed an organized criminal network that stole from American taxpayers by billing $14.6 billion for services never provided, with some perpetrators operating from as far away as Russia and Pakistan.
Key Takeaways
- The Department of Justice has charged over 320 individuals in the largest healthcare fraud takedown in history, involving $14.6 billion in false claims.
- Transnational criminal organizations used sophisticated methods including stolen identities of seniors to submit fraudulent claims to Medicare and other federal programs.
- Nearly 100 licensed medical professionals, including 25 doctors, were charged in schemes that involved unnecessary medical procedures and illegal distribution of over 15 million opioid pills.
- Law enforcement has seized over $245 million in assets including cash, luxury vehicles, and cryptocurrency from perpetrators based in multiple countries.
- CMS Administrator Dr. Mehmet Oz announced the establishment of a new fraud war room to combat these sophisticated criminal syndicates.
International Criminal Networks Target Medicare
The Department of Justice announced charges against more than 320 defendants in what officials are calling an unprecedented crackdown on healthcare fraud. The schemes attempted to defraud Medicare, Medicaid, and other taxpayer-funded health insurance programs out of approximately $14.6 billion. Federal authorities report actual losses of $2.9 billion before the schemes were disrupted, highlighting the massive scale of this criminal enterprise.
Matthew Galeotti, principal deputy assistant attorney general, emphasized the severity of these crimes: “defendants also attempted to swindle Medicare and other taxpayer-funded and private health insurance programs out of about $14.6 billion.” He further stressed this represents the “largest coordinated healthcare fraud takedown in the history of the Department of Justice.”
Sophisticated Criminal Operations
These weren’t small-time scammers but sophisticated criminal syndicates. Dr. Mehmet Oz, current CMS Administrator under President Trump, noted, “It’s not done by small time operators.” The most significant case involved a transnational criminal organization that submitted an astounding $10.6 billion in fraudulent claims using stolen identities of American seniors. The operation, dubbed “Gold Rush,” led to charges against 19 defendants with arrests spanning from Estonia to U.S. airports and the Mexican border.
“These criminals didn’t just steal someone else’s money. They stole from you,” said Matthew Galeotti, highlighting the direct impact on American taxpayers.
Many perpetrators operated from Russia, Eastern Europe, and Pakistan, using advanced tactics to penetrate our healthcare system. The criminals often used stolen identities from seniors to falsely bill the government for services never rendered. This targeting of vulnerable Americans adds a particularly heinous dimension to these crimes.
Opioid Distribution and Unnecessary Procedures
Beyond billing fraud, the schemes included the distribution of over 15 million opioid pills to drug dealers and performing unnecessary medical procedures on elderly patients. Dr. Maryam “Meg” Qayum was implicated in writing prescriptions for over 3 million opioid pills alone. Five medical professionals in Nevada and Arizona submitted $1.1 billion in fraudulent claims for unnecessary skin grafts, while another scheme involved fraudulent billing of $650 million to Arizona Medicaid for addiction treatment.
“Health care fraud isn’t just theft — it’s trafficking in trust. Today’s announcement shows that when doctors become drug dealers and treatment centers become profit-driven fraud rings, [the Drug Enforcement Administration] will act,” said Acting DEA Administrator Robert Murphy.
Administration Takes Strong Action
The Trump administration has demonstrated its commitment to protecting taxpayer dollars and the integrity of healthcare programs. Attorney General Pam Bondi made the administration’s position clear: “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.” Law enforcement has already seized over $245 million in cash, luxury vehicles, cryptocurrency, and other assets from the perpetrators.
Dr. Oz announced the establishment of a new fraud war room at CMS to combat these activities more effectively. This proactive approach is crucial considering CMS is responsible for $1.7 trillion in annual disbursements, making it a prime target for criminal organizations. Nearly 190 federal cases and over 90 state cases have been charged or unsealed since June 9, demonstrating the administration’s swift and coordinated response to these crimes.
