DOJ announces largest health care fraud bust in history: 324 charged in $14.6B scheme

The Department of Justice unveiled a record-breaking health care fraud takedown, charging 324 defendants linked to over $14.6 billion in false claims. DOJ officials say the schemes involved transnational criminal networks, identity theft of over 1 million Americans, and corrupt medical professionals fueling the opioid crisis. “These criminals didn’t just steal someone else’s money. They stole from you,” warned DOJ Criminal Division Chief Matthew Galeotti.

Video transcript:

my name is Matthew Gallotti and I’m the head of the Justice Department’s criminal division thank you all for joining us today as we announce the largest coordinated healthc care fraud takedown in the history of the Department of Justice today marks a decisive moment in our fight to protect American taxpayers from fraudsters and to defend the integrity of America’s health care system we are announcing today charges against 324 defendants for their alleged participation in healthc care fraud schemes involving approximately 14.6 billion dollar in false claims submitted to Medicare Medicaid and other healthc care programs in a takedown this large I can’t possibly describe all of the work that went into dismantling each scheme but there are four key points that bear emphasizing first let me be clear about what these healthc care fraud schemes mean for every hardworking American family these criminals didn’t just steal someone else’s money they stole from you every fraudulent claim every fake billing every kickback scheme represents money taken directly from the pockets of American taxpayers who fund these essential programs through their hard work and sacrifice and when criminals defraud these programs they’re not just committing theft they’re driving up our national deficit and threatening the long-term viability of health care for seniors disabled Americans and our most vulnerable citizens this enforcement action involves a seizure of cash as well as luxury vehicles and properties returning real money to American taxpayers and to our government healthcare programs second we are seeing a disturbing trend of transnational criminal organizations engaging in increasingly sophisticated and complex criminal schemes that defraud the American health care system as part of this takedown we’ve identified and charged defendants operating from Russia Eastern Europe Pakistan and other foreign countries these individuals have infiltrated our health care system to steal American taxpayer dollars as just one example we dismantled a scheme involving a sophisticated operation run from Russia and Eastern Europe that strategically bought dozens of medical supply companies in the United States and submitted more than $10 billion in fraudulent healthcare claims to Medicare to make matters worse these perpetrators used the stolen identities of more than 1 million Americans spanning all 50 states to perpetrate this scheme and submit these false claims but I’m pleased to report that federal agents intercepted and arrested key members of that organization at US airports and the US Mexico border cutting off their intended escape routes the days of transnational criminal organizations using the American health care programs as their personal piggy bank are over third this takedown resulted in criminal charges against 74 defendants including medical professionals who fueled America’s deadly opioid crisis for personal profit these are not isolated instances of poor judgment these are calculated schemes designed to exploit Americans struggling with addiction while enriching the very people who were dutybound to help them heal we charged pill mill operators who prescribed unnecessary opioids we dismantled networks of corrupties that existed solely to distribute drugs to addicts and dealers feeding the addiction crisis that has devastated so many American communities this is not healthcare it is a staggering breach of trust and under my leadership the criminal division will prosecute these criminals as aggressively as we would any drug dealer because that’s exactly what they are fourth many of the defendants charged as part of this takedown specifically targeted our most vulnerable citizens elderly Americans in nursing homes individuals with disabilities those battling serious serious illnesses and more for example our prosecutors charged seven defendants including five medical professionals in connection with approximately 1 billion dollars in fraudulent claims to Medicare and other healthc care benefit programs for performing medically unnecessary skin grass on dying patients as they were seeking to spend their final days with dignity and peace that conduct is exactly as callous and disturbing as it sounds patients and their families trusted these providers with their lives instead of receiving care they became victims of elaborate criminal schemes today’s takedown marks a historic day in addition to the tireless work of our fraud sections healthcare fraud unit this extraordinary effort would not have been possible without the law enforcement agencies with me here today Health and Human Services Centers for Medicare and Medicaid Services the Federal Bureau of Investigation and the Drug Enforcement Administration and of course countless partners across the federal state and local law enforcement community and dozens of United States Attorney’s offices thank you to all who made today possible now despite these historic achievements we aren’t resting on our laurels we’re making advancements to stay ahead of their criminals and their illicit schemes that is why today I’m also announcing that we are working with our partners at FBI HHS II and other federal agencies to create a healthc care data fusion center to re revolutionize how we detect investigate and prosecute healthcare fraud these efforts will be led by the criminal division specifically the fraud section’s healthcare fraud unit and comprised of data specialists from the unit’s data analytics team the Fusion Center will break down information silos using coordinated data analysis to enable our investigative teams to quickly identify and dismantle emerging fraud schemes preventing money from going out the door today’s enforcement action represents the largest healthc care fraud takedown in American history but it’s not the end it’s the beginning of a new era of aggressive prosecution and datadriven prevention thank you

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