Latest news with #OperationGoldRush
Yahoo
12-07-2025
- Yahoo
Nurse accused of taking bribes for 'unnecessary' prescriptions, part of $14B case involving Russian criminals
Ever wonder what a $200 cash bribe might get you at your doctor's office? For certain patients of one Connecticut nurse, such a bribe apparently bought them prescriptions for medications they didn't need — and for the nurse, it bought a one-way ticket to federal indictment. I'm 49 years old and have nothing saved for retirement — what should I do? Don't panic. Here are 6 of the easiest ways you can catch up (and fast) Thanks to Jeff Bezos, you can now become a landlord for as little as $100 — and no, you don't have to deal with tenants or fix freezers. Here's how Want an extra $1,300,000 when you retire? Dave Ramsey says this 7-step plan 'works every single time' to kill debt, get rich in America — and that 'anyone' can do it Michele Rene Luzzi Muzyka, a 60-year-old advanced practice registered nurse in Cheshire, Connecticut, now finds herself caught in the Justice Department's net following the largest health care fraud sweep in American history. Codenamed 'Operation Gold Rush,' the nationwide crackdown identified a staggering $14.6 billion in fraudulent claims, resulting in charges against more than 300 defendants, according to WFSB. The numbers tied to this case are truly staggering: 324 defendants — including 96 health care professionals — now face charges across 50 federal districts and 12 state Attorneys General Offices. Doctors, nurse practitioners and pharmacists are reportedly among the 96 health care professionals arrested. But while $14.6 billion was bilked from the health care system, authorities have so far managed to recover about $245 million in assets, ranging from cash to luxury vehicles. According to federal prosecutors, Muzyka's alleged scheme was relatively straightforward — and brazenly illegal: patients would show up, hand over $200 in cash and walk out with prescriptions for controlled substances they couldn't get through legal means. But what Muzyka didn't know was that one of those 'patients' was actually an undercover agent posing as a Medicaid beneficiary who paid Muzyka the $200 fee and received an illegal prescription. While Muzyka's case is shocking on its own, it's just one thread in a massive criminal operation that federal investigators have been unraveling. Muzyka's arrest came as part of an investigation into a Russian criminal organization that had established elaborate health care fraud operations in Connecticut. This transnational crime syndicate allegedly purchased dozens of legitimate companies that already had Medicare billing privileges and used them to submit millions of dollars in fraudulent claims. This criminal organization also reportedly stole thousands of identities — particularly targeting vulnerable elderly and disabled Americans — and funneled millions overseas to China and Malaysia. Read more: Americans are 'revenge saving' to survive — but millions only get a measly 1% on their savings. When Medicare and Medicaid funds are fraudulently stolen, everyone in America — from individuals to businesses — are affected. 'Don't be fooled into thinking that health care fraud is a victimless crime,' states the National Health Care Anti-Fraud Association. 'Fraudulent claims carry a very high price tag, both financially and in how they impact our perception of the integrity and value of our health care system.' Health care fraud causes tens of billions of dollars in Medicare and Medicaid losses each year, according to the FBI, and such losses can put increased pressure on these programs. This can translate into stricter coverage policies, higher premiums and reduced benefits for the millions of Americans who depend on these programs for their health care. The involvement of health care professionals in these schemes is particularly troubling. When providers like Muzyka illegally prioritize profit over patient care, it erodes the fundamental trust between health care providers and patients. This tiny hot Costco item has skyrocketed 74% in price in under 2 years — but now the retail giant is restricting purchases. Here's how to buy the coveted asset in bulk Here are the 6 levels of wealth for retirement-age Americans — are you near the top or bottom of the pyramid? Rich, young Americans are ditching the stormy stock market — here are the alternative assets they're banking on instead Here are 5 'must have' items that Americans (almost) always overpay for — and very quickly regret. How many are hurting you? Money doesn't have to be complicated — sign up for the free Moneywise newsletter for actionable finance tips and news you can use. This article provides information only and should not be construed as advice. It is provided without warranty of any kind.
Newsweek
09-07-2025
- Newsweek
Four Things To Know About the Biggest Health Care Fraud in US History
Advocates for ideas and draws conclusions based on the interpretation of facts and data. Newsweek AI is in beta. Translations may contain inaccuracies—please refer to the original content. The Department of Justice recently announced the largest health care fraud bust in U.S. history. After a two-year investigation dubbed "Operation Gold Rush" led by the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG), 19 people were charged with multiple crimes related to an alleged $10.6 billion Medicare fraud scheme. The scale and complexity of the fraud are enormous. A foreign crime ring obtained stolen personal information of more than 1 million Americans, purchased dozens of U.S. health care supply companies, and then submitted fraudulent claims to Medicare for more than 1 billion urinary catheters and other supplies. The U.S. Treasury Department and Inspector General Office are pictured. The U.S. Treasury Department and Inspector General Office are pictured. Getty Images The good news is that Medicare and HHS OIG officials moved quickly to identify the fraudulent bills and stop payments before funds were dispersed, preventing more than 99 percent of the Medicare payments from reaching the alleged fraudsters. Although Medicare did pay a portion of the claims to the conspirators, government officials reportedly seized tens of millions of dollars of those ill-gotten gains. The bad news is that the perpetrators apparently collected about $1 billion from Medicare supplemental insurance companies. Beyond the eye-popping scope of the scheme, Americans should pay attention to four important elements of this fraud scheme. First, this operation illustrates the vital importance of having strong inspectors general (IG) protecting tax dollars. IGs, the internal watchdogs who root out fraud and waste in our federal government, have been under attack from the Trump administration, including the recent firing of 17 IGs (including me). As evidenced by Operation Gold Rush, IGs provide invaluable oversight to improve federal agencies and protect taxpayers' dollars. Every American should demand independent and effective IGs. Second, this fraud scheme lays bare a long-standing need to strengthen Medicare data harvesting and analytics. When I was leading U.S. Senate investigations, our analysis revealed that Medicare paid hundreds of thousands of claims totaling $60 million to $100 million even though the prescribing doctor had died years earlier—five, 10, or even 15 years before the date of the prescription. Notably, our report and committee hearings occurred 17 years ago, flagging that HHS OIG identified similar problems seven years prior. One of our 2008 investigations reviewed millions of Medicare claims and found highly questionable diagnoses and related medical equipment prescriptions. For example, we reviewed hundreds of thousands of claims paid by Medicare for blood test strips for diabetics, but we found diagnoses totally unrelated to diabetes—from the bubonic plague to tuberculous. Our 2008 rudimentary data analytics revealed these anomalies, a figurative abacus compared to the sophisticated analytics technology OIGs and federal staff have nowadays. One hopeful sign: the Department of Justice (DOJ) announced the creation of a Health Care Fraud Data Fusion Center to facilitate agencies' use of cloud computing, artificial intelligence, and advanced analytics to share information, identify fraud schemes, and proactively prevent improper payments. Third, Operation Gold Rush highlights how international fraud rings have infiltrated federal programs to steal personal information and American tax dollars. In this case, the criminals came from Estonia, Kazakhstan, and Russia. "A majority of the fraud," one HHS OIG official told The Washington Post, "occurred by individuals who never even set foot in the United States." IGs have identified foreign crime rings as a major problem in a variety of programs, such as unemployment insurance and pandemic benefits, for years. Finally, this case relates to a "pay-and-chase" model. Typically, federal agencies pay claims quickly, then identify fraud and chase the fraudsters to recover ill-gotten money. Given the sophisticated games that criminals now play, especially in the international context, the pay-and-chase model is rarely effective in deterring fraud and recovering stolen money. By the time law enforcement discovers the fraud, the money is long gone. Operation Gold Rush seems to represent a shift in how the federal government addresses fraud. The IG community has long urged agencies to shift from pay-and-chase to instead implementing anti-fraud measures before issuing payments. Agencies historically have put a thumb on the scale in favor of paying quickly, which raises fraud risks. With the advent of AI and sophisticated data analytics tools, the IG community and feds can do both: triage claims to prevent fraud and pay claims quickly. All told, Operation Gold Rush shows inspectors general are on the frontlines of the fight against fraud to stay ahead of sophisticated international crime rings stealing our tax dollars. It is more urgent than ever that we have independent, experienced IGs in place to proactively fend of increasingly sophisticated criminal networks. Now is the time to properly fill open IG positions and invest in this crucial law enforcement resource to prevent the next gold rush. Mark Lee Greenblatt is an expert on government ethics and compliance, an attorney, and author. Most recently, he served as inspector general for the U.S. Department of the Interior. From 2019 to 2025, Mr. Greenblatt led a team of nearly 300 investigators, auditors, and attorneys responsible for oversight of more than 70,000 agency employees. The views expressed in this article are the writer's own.
Forbes
02-07-2025
- Forbes
$14.6 Billion Scam Busted: 324 Charged In DOJ's Biggest Health Care Takedown
Department of Justice On Monday, the U.S. Department of Justice unveiled the results of its largest-ever coordinated health care fraud takedown, charging 324 defendants across the country in connection with more than $14.6 billion in alleged fraudulent claims. This announcement marks a watershed moment in federal law enforcement's efforts to combat health care fraud and protect taxpayer dollars. A Record-Setting Operation The DOJ's 2025 National Health Care Fraud Takedown, publicized on June 30, involved criminal charges against a broad array of defendants, including ninety-six doctors, nurse practitioners, pharmacists and other licensed medical professionals spanning fifty federal districts and twelve State Attorneys General's Offices. The government seized over $245 million in cash, luxury vehicles, cryptocurrency and other assets, while the Centers for Medicare and Medicaid Services, or CMS, reported preventing more than $4 billion in fraudulent payments by suspending or revoking the billing privileges of 205 providers in the months leading up to the takedown. Unprecedented Scope and Impact This year's takedown eclipses previous records, both in terms of the number of individuals charged and the scope of the alleged fraud. The operation targeted schemes involving durable medical equipment, telemedicine and transnational criminal organizations, including cases like 'Operation Gold Rush,' which alone accounted for $10.6 billion in fraudulent claims and involved actors with ties to organized crime in Russia, Estonia and Kazakhstan. Attorney General Pamela Bondi emphasized the administration's zero-tolerance stance, "this record-setting Health Care Fraud Takedown delivers justice to criminal actors who prey upon our most vulnerable citizens and steal from hardworking American 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.' The announcement signals a new era of enforcement, with federal authorities leveraging advanced analytics and multi-agency cooperation to root out fraud. The DOJ, FBI, DEA, HHS-OIG and numerous state agencies collaborated in this action.
Newsweek
01-07-2025
- Health
- Newsweek
Doctor Accused of Diverting Drugs from Kids Involved in FBI Investigation
Based on facts, either observed and verified firsthand by the reporter, or reported and verified from knowledgeable sources. Newsweek AI is in beta. Translations may contain inaccuracies—please refer to the original content. More than 320 individuals, including 25 doctors, have been federally charged in connection with nearly $15 billion in alleged false claims, in what the Justice Department marked as the largest coordinated health care fraud takedown in U.S. history, Newsweek previously reported. Among the accused, a Washington state doctor who reportedly diverted prescription drugs originally intended for children, a press release from the Western District of Washington said. Anesthesiology resident Andrew Voegel-Podadera, 35, of Seattle, Washington, faces a criminal case after being accused of obtaining controlled substances by fraud in connection with a scheme to divert medications for his own use, according to the release. Newsweek has reached out to an attorney for Voegel-Podadera and Seattle Children's Hospital for comment via email Tuesday afternoon. Why It Matters The discovery of the diversion highlights the vulnerability of both the patients and the medical systems that rely on doctors. It also underscores the larger picture of fraud occurring in medical settings, including the crimes in the wider healthcare fraud case uncovered by the DOJ. The doctor not only used his position to steal the drugs, but also, as the release alleges, used those drugs while working at the hospital. What To Know Voegel-Podadera allegedly used his position as an anesthesiology resident to take "fentanyl, hydromorphone, and other medications over the course of at least a year while working at Seattle Children's Hospital, Harborview Medical Center, and University of Washington Medical Center," the release said. "He sometimes used the diverted substances while still at the hospital, meaning he was under the influence of potent narcotics while treating patients," the release added. The medications were intended for patients who were receiving care at the children's hospital for a variety of treatments. "Diverting medicine away from infant patients is despicable, doubly so if the person involved is a doctor," said David F. Reames, Special Agent in Charge, DEA Seattle Field Division said in the press release, adding, "If Dr. Voegel-Podadera is convicted, it will show that he violated both his oath and the law, and I am proud that DEA could help stop him." Voegel-Podadera's involvement is just a fraction of the larger fraud that authorities uncovered, with officials identifying perpetrators not just in the United States but also in Russia, Eastern Europe, Pakistan, and other countries. Authorities attributed the scale of losses to the increasing sophistication and coordination of transnational syndicates, using methods such as foreign straw owners and stolen personal information to file false claims. One of the headline investigations, dubbed Operation Gold Rush, centered around a $10 billion urinary catheter scheme. The fraudulent schemes drained billions from federally funded programs like Medicare and Medicaid, directly undermining trust and reducing available resources for legitimate patients. What People Are Saying Acting U.S. Attorney Miller said in the press release: "The medical resident stole narcotics and used them while at work in the UW hospital system, putting patients in jeopardy." Matthew Galeotti, head of DOJ's criminal division, said in the press release: "Every fraudulent claim, every fake billing, every kickback scheme represents money taken directly from American taxpayers, who fund these essential programs through their hard work and sacrifice." What Happens Next Voegel-Podadera made an initial appearance last week, U.S. Attorney's Office Communications Director Emily Langlie said in an email to Newsweek. Langlie said if Voegel-Podadera is indicted by the grand jury, it would be during his next appearance. It is also unknown what penalties he could face, including loss of medical license to practice. Criminal proceedings are ongoing across multiple federal and state jurisdictions, with some cases—like those related to Operation Gold Rush and Western Washington pediatric drug diversion—still in early stages.
Indian Express
01-07-2025
- Indian Express
More than 300 charged in $14.6 billion health care fraud schemes takedown, Justice Department says
State and federal prosecutors have charged more than 320 people and uncovered nearly $15 billion in false claims in what they described Monday as the largest coordinated takedown of health care fraud schemes in Justice Department history. Law enforcement seized more than $245 million in cash, luxury vehicles, cryptocurrency, and other assets as prosecutors warned of a growing push by transnational criminal networks to exploit the US health care system. As part of the sweeping crackdown, officials identified perpetrators based in Russia, Eastern Europe, Pakistan, and other countries. 'These criminals didn't just steal someone else's money. They stole from you,' Matthew Galeotti, who leads the Justice Department's criminal division, 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.' The alleged $14.6 billion in fraud is more than twice the previous record in the Justice Department's annual health care fraud crackdown. It includes nearly 190 federal cases and more than 90 state cases that have been charged or unsealed since June 9. Nearly 100 licensed medical professionals were charged, including 25 doctors, and the government reported $2.9 billion in actual losses. Among the cases is a $10 billion urinary catheter scheme that authorities say highlights the increasingly sophisticated methods used by transnational criminal organizations. Authorities say the group behind the scheme used foreign straw owners to secretly buy up dozens of medical supply companies and then used stolen identities and confidential health data to file fake Medicare claims. Nineteen defendants have been charged as part of that investigation — which authorities dubbed Operation Gold Rush — including four people arrested in Estonia and seven people arrested at US airports and at the border with Mexico, prosecutors said. The scheme involved the stolen identities and personal information of more one million Americans, according to the Justice Department. 'It's not done by small time operators,' said Dr. Mehmet Oz, who leads the Centers for Medicare and Medicaid Services. 'These are organized syndicates who are designing to hurt America.'
