Historic $14.6 billion health care fraud crackdown announced by DOJ and FBI. 324 charged in nationwide schemes involving Medicare, Medicaid, and private insurers. Operation Gold Rush leads largest enforcement effort in U.S. history.
WASHINGTON, D.C. — On June 30, 2025, federal officials announced the largest health care fraud crackdown ever—resulting in charges against 324 individuals, including 96 licensed medical professionals, in schemes that allegedly defrauded Medicare, Medicaid, and private insurers of $14.6 billion, with estimated actual losses of about $2.9 billion .
The operation brought together the DOJ, FBI, HHS-OIG, DEA, and 12 state attorneys general, spanning all 50 federal districts. It led to the seizure of over $245 million in assets—cash, luxury vehicles, and crypto—and CMS proactively halted more than $4 billion in fraudulent payments. At the center: Operation Gold Rush
This transnational fraud involved a group tied to Eastern Europe and Russia that used stolen U.S. identities to covertly acquire over 30 durable medical equipment suppliers. They submitted more than $10.6 billion in false Medicare claims for items like catheters and glucose monitors using personal information from over 1 million Americans .
While CMS intercepted more than 99 % of Medicare payments, supplemental insurers still paid out nearly $1 billion before intervention . Once victims began receiving unrequested medical items, agency investigations intensified.
FBI Director Kash Patel said, “Health care fraud drains critical resources from programs intended to help people who truly need medical care. Today’s announcement demonstrates our commitment… With more than $13 billion in fraud uncovered, this is the largest takedown for this initiative to date.” Widespread fraud beyond DME
The sweep also included:
- $1.17 billion in telemedicine and genetic testing fraud (49 defendants)
- Illegal opioid diversion involving over 15 million pills (74 defendants)
- $1.1 billion in amniotic allograft billing fraud (7 providers)
- Additional kickback and referral schemes totaling roughly $1.84 billion in false claimsMatthew R. Galeotti, Chief of the DOJ Criminal Division’s Fraud Section, told reporters, “This is the beginning of a new era of aggressive prosecution and data‑driven prevention”
Fraud fighting goes high-tech A new Health Care Fraud Data Fusion Center is operational, featuring AI-powered analytics that analyze complex billing trends in real-time.
Awareness in the Filipino‑American community
DOJ filings show no indications that Filipino‑American health professionals are among those charged. But legal experts reiterate that many fraud schemes stem from stolen data or shell contracts, not frontline provider misconduct.
Public advised to be alert
Medicare beneficiaries are urged to review Explanation of Benefits notices carefully. Fraud can be reported via 1‑800‑HHS‑TIPS or through oig.hhs.gov.
