Justice Department announces $14B in healthcare fraud ‘takedown’ By HPN Staff The U.S. Department of Justice has broken up a series of allegedly fraudulent schemes in the health sector worth more than $14 billion — a move that foreshadows a wider crackdown by the Trump administration on potential fraud and waste in taxpayer-funded health care programs. Dubbed the “National Health Care Fraud Takedown,” federal prosecutors announced charges against more than 300 defendants — including 96 doctors, nurse practitioners and pharmacists — across a series of separate criminal and civil cases. The total scale of the alleged fraud was a record-setting $14.6 billion, U.S. Attorney General Pamela Bondi said on June 30, and investigators have seized more than $245 million in cash, luxury vehicles, cryptocurrency and other assets. The action by federal and state law enforcement officials “delivers justice to criminal actors who prey upon our most vulnerable citizens and steal from hardworking American taxpayers,” Bondi said. “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.” Why it matters Health care programs – including Medicare and Medicaid – account for more than one-quarter of federal spending and are collectively the largest spending category of the federal budget. In 2024, the total cost of these programs was approximately $1.9 trillion, according to the Kaiser Family Foundation. Federal lawmakers have come under increasing pressure to limit federal spending, with the national debt currently exceeding $36 trillion, roughly 20% higher than the total gross domestic product of the U.S. economy. As part of their recently passed budget plan, Republicans in Congress and the Trump administration have pledged to find savings in federal health care spending by identifying and eliminating “waste, fraud and abuse.” Democrats in Congress and other critics of the budget plan — dubbed the One Big Beautiful Bill Act — have argued that Republicans are exaggerating the amount of waste and fraud in federal health programs and that any savings will actually come from reducing benefits and services to patients. More detail Federal prosecutors outlined a series of alleged schemes across the healthcare sector, including: $12 billion in fraudulent claims from transnational criminal organizations that exploited stolen identities, sophisticated money laundering techniques and fake voice recordings of Medicare beneficiaries generated with artificial intelligence. The illegal diversion of more than 15 million prescription opioid pills to the black market, including a Texas pharmacy that distributed 3 million of these pills alone. More than $1.8 billion in fraudulent claims for medically unnecessary services, kickbacks or services never provided — including the theft of prescription fentanyl and hydrocodone that was intended for patients, including children. Almost $1.2 billion in telemedicine and genetic testing fraud, often involving deceptive telemarketing practices. Roughly $1.1 billion in fraudulent claims for unnecessary wound care, primarily targeted at elderly patients. The bigger picture The scale of the announced prosecutions and civil actions reflects a new approach to combating fraud, the Justice Department said. Federal prosecutors are working more closely with the Department of Health and Human Services, the Centers for Medicare and Medicaid Services, the Federal Bureau of Investigation and the Drug Enforcement Administration. The coordination will get even tighter with the creation of a Health Care Fraud Data Fusion Center, which will allow investigators and agency-level experts to leverage cloud computing, artificial intelligence, and advanced analytics to identify emerging health care fraud schemes, officials said.
