Largest Healthcare Fraud Takedown in U.S. History Announced by DOJ
Over $14 billion in fraudulent claims identified as part of a significant crackdown involving international criminal networks.
The Department of Justice (DOJ) and the Federal Bureau of Investigation (FBI) have announced the largest coordinated action against healthcare fraud in U.S. history, resulting in more than 320 arrests and the identification of approximately $14.6 billion in fraudulent claims submitted to Medicare, Medicaid, and other health care programs.
In this extensive operation, law enforcement officials seized over $245 million in cash, luxury vehicles, cryptocurrency, and other assets connected to these fraudulent activities.
Prosecutors have reported that the alleged fraud is more than double the previous record during the Justice Department’s annual healthcare fraud crackdown.
Matthew Galeotti, the head of the Criminal Division at the DOJ, stated that the fraudulent activities not only represent significant financial losses for taxpayers but also reflect a broader trend of exploitation by transnational criminal networks aiming to infiltrate the U.S. healthcare system.
Authorities indicated that the fraud identified includes nearly 190 federal cases and over 90 state cases that have been charged or unsealed since June 9, with nearly 100 licensed medical professionals, including 25 physicians, implicated in the schemes.
The government has reported actual losses in the realm of $2.9 billion associated with these fraudulent claims.
The operation has unveiled an international dimension, with perpetrators linked to countries including Russia, Eastern Europe, and Pakistan, highlighting the complexity and global nature of these fraud schemes.
In a related political development, the Senate recently rejected a measure aimed at removing approximately 1.4 million undocumented immigrants from Medicaid.
This vote was affected by a procedural change enacted by the Senate Parliamentarian, which raised the threshold from 50 to 60 votes needed for this measure, an unusual move as the 50-vote threshold has been standard since the establishment of the Senate in 1789.
The decision to maintain the higher threshold has drawn scrutiny from lawmakers, particularly among those advocating for stricter immigration controls and responsible fiscal management regarding taxpayer-funded programs.
Senate Majority Leader John Thune is facing calls from some members of his party to address the Parliamentarian's rulings, which are perceived as hindering legislative efforts to enact changes in Medicaid eligibility.