Newou can listen to Fox News articles!
This week, the Department of Justice announced on charges of wiped charges against more than 300 defendants allegedly scamming Medicare and other taxpayer-funded programs.
The takedown of healthcare fraud has been a practice at DOJ for over a decade, but authorities have touted it as the biggest on record. It stood out not only because of its size, but also because it focused on cross-border criminals and artificial intelligence broached.
“This takedown represents the biggest healthcare scam in American history,” said Matthew Galeotti, DOJ’s Criminal Division Chief. “But that’s not the end. It’s the beginning of a new era of offensive prosecution and data-driven prevention.”
This year’s business has resulted in 324 defendants being accused of filing billions of dollars in fraudulent medical claims for medical care, including those patients did not receive or unnecessarily received.
The multi-billion dollar healthcare fraud scheme involved giving people to “unnecessary” skin grafts: DOJ
Matthew Galeotti, the Department of Justice’s Criminal Director, will speak at a Left Conference attended by administrators of the Centers for Medicare and Medicaid Services, at a press conference held at Washington, DC (Kevin Diet/Getty Images) on June 30, 2025, in Washington, DC (Kevin Diet/Getty Images) at the US Department of Justice’s biggest healthcare fraud case in history.
DOJ officials told reporters that the takedown was “strategically adjusted” to relate to “all new prosecutions, complaints.” [and] information. ”
The charges came to 50 federal districts, and officials said everyone was brought or not sealed in the three weeks leading up to the announcement of the takedown.
Galeotti said the intended false claims totaled $14.6 billion, with actual losses reaching $2.9 billion.
Another DOJ official told Fox News Digital that the annual Takedowns aims to “raising public awareness and preventing fraudsters from becoming involved in the crime.” Officials said the 2019 takedown, Operation Brace Yourself, led to an estimated $1.9 billion cut to Medicare for certain types of orthodontics.
“All fraudulent claims, all fake claims, all kickback schemes represent money taken directly from the pockets of American taxpayers who fund these important programs through hard work and sacrifice,” Galeotti said.
International fraud
The charges released this week extend to Globe, with DOJ officials saying that in addition to the four people arrested in Estonia and four people arrested at the airport or the US-Mexico border, the department is working to extradite others accused of the crime.
Feds Bust Armenian Fraud Ring has been accused of stealing $30 million on Covid, small business loans
The 2025 National Healthcare Fraud discovered $14.6 billion in fraud losses, with 324 people being charged with crimes. (Ministry of Justice)
These defendants were part of a suspected scheme called the “Gold Rush Operation,” in which at least 20 members of multinational criminal organizations, including the Russian-based defendants, were allegedly accused of being part of a catheter-centered Medicare and money laundering operation.
The group behind the scheme has used foreign ownership to purchase dozens of medical supplies and created and filed a $10.6 billion claim on Medicare using stolen identity and confidential health data.
“We see a disturbing trend in transnational criminal organizations engaged in increasingly sophisticated and complex crime plans that deceive the American health care system,” Galeotti said.
The two owners of the Pakistani marketing organization were among those charged with a $703 million scheme that allegedly used artificial intelligence to create fake recordings of Medicare recipients who agreed to receive medical supplies.
“We are clearly worried about advances in technology criminals here,” Galeotti said.
Dr. Mehmet Oz, the center for Medicare and Medicaid Services Administrators who oversees Medicare programs, was forced by reporters on why fraudsters can easily break into the Medicare payment system.
Oz said CMS was working to meet at the moment. The agency “already launched the model. It is designed to use artificial intelligence and other cutting-edge tools to address the scams that exist in healthcare,” Oz said.
Behind the scenes
Investigating and prosecuting fraudsters is a highly data-dependent task. DOJ’s healthcare fraud unit has its own internal team to analyze data since 2018, one DOJ official told Fox News Digital.
Team methods include identifying “abnormal billing levels” and other suspicious billing patterns, as well as fraud that appear to move from one region to another. The ability of teams to identify emerging trends, such as medical professionals who use skin grafts for wound care, can also help.
FBI Director Kash Patel records a bust of drugs. The seized drugs could have killed nearly 50 million people
Close-up shot of a doctor’s hand holding and giving it to a patient. (istock)
One charge in Takedown involved three Arizona defendants who allegedly purchased these types of skin grafts known as “amnionitis wound allografts,” and applied unnecessarily on the last day to older Medicare beneficiaries, including hospice patients. The defendant is said to have reaped millions of dollars from the practice.
“Patients and their families trusted these healthcare providers in their lives. Instead of receiving care, they became victims of elaborate criminal planning,” Galeotti said.
A DOJ official said it plans to use the “fusion centre” as part of its crackdown on healthcare fraud. The center is designed to combine data between agents to create a more efficient analytical process.
The Drug Enforcement Agency (DEA) is also involved in healthcare fraud work. DEA officials said in a Takedown announcement that the agency’s investigation includes doctors, pharmacists and pharmacy owners.
Click here to get the Fox News app
The 58 cases included an illegal distribution of an estimated 15 million tablets of opioids and other controlled substances, he said.
“These pills ended on our streets on dealer’s hands and on the path of addiction,” a DEA official said.
Overall, dozens of medical professionals, including 25 doctors, have been charged with takedowns.
Ashley Oliver is a reporter for Fox News Digital and Fox Business, covering the Department of Justice and legal affairs. Email story tips to Ashley.oliver@fox.com.
Source link
