DOJ takes down sick $14.6 billion healthcare fraud scheme that saw patients given ‘unecessary' procedures

New York Post

20 hours ago

WASHINGTON — Hundreds were charged Monday in connection with a $14.6 billion healthcare fraud scheme that supplied millions of opioid pills to drug dealers and saw elderly patients given 'unnecessary' wound grafts, the Department of Justice announced.
The operation, which the department called the largest healthcare fraud takedown in its history, collared 324 defendants, including members of transnational criminal groups and American doctors and pharmacists.
The sick scheme sought to bilk the federal government out of $14.6 billion, with the actual loss to the US government totaling about $2.9 billion, officials said.
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6 Hundreds were charged Monday in connection with the largest health care fraud in history that involved $14.6 billion in potential schemes, the Department of Justice revealed Monday.
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The feds seized as much as $245 million 'in cash, luxury vehicles, cryptocurrency, and other assets' in the sweeping crackdown, the DOJ said, and stopped $4 billion from going out the door to the health care fraudsters.
Another $48.6 million in alleged civil fraud charges and civil settlements related to the schemes were also disclosed.
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Of the nearly 200 federal cases and 90 state cases involved, almost $3 billion in funds were actually swindled from US taxpayers.
'Make no mistake — this administration will not tolerate criminals who line their pockets with taxpayer dollars while endangering the health and safety of our communities,' Bondi added.
DOJ Criminal Division head Matthew Galeotti said that some of the ill-gotten gains came at the cost of exacerbating the nation's opioid epidemic and harming those fighting against drug addiction.
One scheme involved the trafficking of more than 15 million prescription opioid pills — including oxycodone, hydrocodone and carisoprodol — from pharmacists to street drug dealers to users.
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'Health care fraud isn't just theft — it's trafficking in trust. Today's announcement shows that when doctors become drug dealers and treatment centers become profit-driven fraud rings, DEA will act,' said Acting Administrator Robert Murphy of the DEA.
6 Former federal prosecutor Neama Rahmani told The Post that the crackdown appeared to be politically motivated, as President Trump has asked Republicans to root out 'waste, fraud and abuse' in Medicaid.
Department of Justice)
Another scheme involved US-based defendants conspiring to take $1.1 billion from Medicare recipients by pressuring them to undergo amniotic wound allografts, in some cases when the procedure was 'unnecessary' since the patients were in hospice and just days or weeks away from death.
Former federal prosecutor Neama Rahmani told The Post that the crackdown appeared to be politically motivated, as President Trump has asked Republicans to root out 'waste, fraud and abuse' in Medicaid through his 'big, beautiful bill' working its way through Congress.
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The most bogus medical claims — around $10.6 billion — were submitted to Medicare by transnational crime organizations that had foreign straw owners from Estonia, Russia and elsewhere buy up dozens of medical supply firms to needlessly purchase urinary catheters and other medical equipment.
The plot involved the theft of more than 1 million Americans' identities nationwide to submit the claims.
6 The plot involved the theft of more than 1 million Americans' identities nationwide to submit the claims.
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Proceeds were then laundered through cryptocurrency exchanges and later into foreign shell companies.
At least 12 culprits were arrested for participating in the scheme, dubbed 'Operation Gold Rush' by the DOJ, four of whom were apprehended in Estonia and seven of whom were taken at US ports of entry.
Additionally, a Pakistan-United Arab Emirates national owned a billing company that tried to charge Medicaid treatment center owners in Arizona roughly $650 million for substance abuse services.
6 'These criminals didn't just steal someone else's money. They stole from you,' Galeotti told reporters Monday.
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The treatments were often poor or not provided at all — and the treatment center owners allegedly paid kickbacks for patients 'recruited from the homeless population and Native American reservations,' DOJ officials said.
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The foreign owner of the billing company nabbed $25 million before the feds got wind and used the money to buy a $2.9 million home at a golf club in Dubai.
6 Genetic testing and telemedicine fraud also bilked taxpayers contributing to Medicare programs by more than $1.1 billion.
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Genetic testing and telemedicine fraud also bilked taxpayers contributing to Medicare programs by more than $1.1 billion.
Scores of other defendants bilked Medicare, Medicaid and private insurers in schemes amounting to $1.84 billion in false claims for medical testing, treatments and visits that involved alleged kickbacks and bribes.
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6 A Pakistani-United Arab Emirates national nabbed $25 million through bogus claims before the feds got wind and used the money to buy a $2.9 million home at a golf club in Dubai.
Christopher Sadowski
'These criminals didn't just steal someone else's money. They stole from you,' Galeotti told reporters Monday.
'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.'