The U.S. Department of Justice announced the largest coordinated health care fraud takedown in its history, charging 324 defendants with schemes involving approximately $14.6 billion in false claims submitted to Medicare, Medicaid, and other government programs.
The enforcement action targets a wide range of alleged misconduct, including transnational criminal organizations operating from Russia, Eastern Europe, Pakistan, and other foreign countries. One specific scheme involved defendants using the stolen identities of more than one million Americans to submit fraudulent claims.
The takedown also includes charges against 74 defendants, including medical professionals, for their roles in fueling the opioid epidemic. These charges target pill mill operators and corrupt pharmacy networks accused of distributing drugs to addicts and dealers for personal profit.
Prosecutors also charged seven defendants, including five medical professionals, with submitting approximately $1 billion in fraudulent claims for medically unnecessary skin grafts performed on dying patients.
In conjunction with the charges, the Department announced plans to establish a Health Care Fraud Data Fusion Center. Led by the Criminal Division’s Fraud Section, the center will utilize data specialists to identify and dismantle emerging fraud schemes.
The Department noted that the takedown involved the seizure of cash, luxury vehicles, and properties intended to return funds to American taxpayers.
The operation was conducted in partnership with the Department of Health and Human Services, the Centers for Medicare & Medicaid Services, the Federal Bureau of Investigation, the Drug Enforcement Administration, and other federal agencies.