WASHINGTON – US Department of Justice pulled back curtain on what is said to be largest healthcare fraud takedown in American history, a criminal operation so massive, and it nearly bled $14.6 billion from federal healthcare programs.
The sprawling sting operation led to charges against 324 individuals, including 96 licensed medical professionals, and triggered a national reckoning over the security of Medicare, Medicaid, and remote healthcare platforms. US officials are describing the scheme as “industrial-scale looting” of public health funds, exploiting every crack in the system from telehealth loopholes and pandemic-era policies to stolen identities and high-tech shell companies.
During detailed probe, it was found that transnational crime syndicate operating out of Pakistan, Europe, Russia and other parts of the country stole identities of over 1 million US residents to unleash flood of fake claims on Medicare.
Using shell companies disguised as legitimate medical suppliers, the fraudsters filed tens of thousands of claims at lightning speed, often targeting elderly and deceased Americans. It’s one of the largest identity-theft-fueled healthcare cons ever recorded.
Investigators uncovered a shadowy web of telehealth rackets, opioid prescription mills, and genetic testing scams—all exploiting the boom in remote medical services that followed the COVID-19 pandemic. One telehealth company in Florida allegedly billed over $30 million for fake consultations using unlicensed staff. In another case, doctors were paid kickbacks to approve expensive and unnecessary genetic tests, some worth up to $15,000 each.
FBI Health Care Fraud Unit Chief Christopher Delzotto said these criminals weaponized the very tools we relied on during a public health emergency. Centers for Medicare & Medicaid Services (CMS) blocked over $4 billion in fraudulent payments before a single dollar could leave the federal treasury. Thanks to cutting-edge data analytics and machine learning, authorities flagged suspicious billing patterns in real time.
Alongside arrests, CMS revoked billing privileges for 205 healthcare providers and announced the launch of a new Health Care Fraud Data Fusion Center, a digital fortress powered by AI, set to hunt down fraud the moment it surfaces.
In NYC, the spotlight turned to a more local, but equally brazen, scheme. More than two dozen non-emergency medical transport companies were caught falsifying toll receipts, inflating trip distances, and billing Medicaid for rides that never happened. The fraud totaled $13 million in bogus charges.
Foreign cybercriminals are increasingly targeting US healthcare systems, weaponizing stolen identities and shell companies to siphon off taxpayer dollars.
