A sweeping move against criminal activity in the U.S. healthcare system, as the Department of Justice has unveiled what it describes as the largest coordinated healthcare fraud takedown in its history. A staggering 324 defendants are being charged for their alleged roles in defrauding Medicare, Medicaid, and other federal healthcare programs, with false claims totaling approximately $14.6 billion.
The nationwide crackdown involved joint efforts from the DOJ, FBI, DEA, and the Centers for Medicare and Medicaid Services (CMS). Dr. Mehmet Oz, recently appointed to lead CMS, appeared at the official announcement and condemned the scale and sophistication of the fraud schemes.
“This is not some small-town scam. These are highly organized criminal syndicates attacking the core of our healthcare system,” Oz stated. “To think that $15 billion could even be on the table for such fraud is appalling. And CMS, with $1.7 trillion in disbursements, is a prime target.”
According to Oz, the criminals often gain access to CMS by stealing personal identifiers from seniors or Medicaid recipients, bypassing existing safeguards. He emphasized that CMS is intensifying efforts to harden its systems and protect vulnerable populations from exploitation.
The operation spanned across 50 federal districts and included the illegal distribution of over 15 million prescription pills. FBI Deputy Director Dan Bongino highlighted the significance of the investigation, both in financial scale and public trust.
“Public corruption and theft of taxpayer money are crimes against all Americans,” Bongino said. “This is the largest healthcare fraud case we’ve ever seen in terms of financial losses — and it’s only the beginning. If you’re stealing from the American people, expect consequences.”
The FBI reports seizing $245 million in assets connected to the fraud. Among those charged were 96 medical professionals, adding a layer of betrayal to the public’s trust in the healthcare community.
Authorities say the fraudulent schemes varied in structure, but most followed a pattern of submitting inflated or entirely fake claims to federal programs in exchange for massive financial gain. Some operations even extended to fraudulent pharmacies and clinics that existed solely to process claims.
The DOJ made clear that this operation is part of a broader strategy to root out fraud and restore faith in federally funded healthcare programs. As prosecutions begin to move forward, federal agencies have signaled that this is just one of many steps in an ongoing battle.
“This is a warning to anyone thinking of abusing our healthcare system,” Bongino concluded. “We will find you, and we will hold you accountable.”
