The US Department of Justice announced Monday that it uncovered the “largest healthcare fraud initiative” in US history, involving 324 healthcare professionals who defrauded the federal government of $14.6 billion.
The DOJ reported the details of those involved in the scheme, who are being criminally charged.
“Specifically 324 defendants, including 96 doctors, nurse practitioners, pharmacists, and other licensed medical professionals, in 50 federal districts and 12 State Attorneys General’s Offices across the United States, for their alleged participation in various health care fraud schemes involving over $14.6 billion in intended loss.”
Mehmet Oz, Administrator for the Centers for Medicare & Medicaid Services, addressed that such fraud is being committed in an organized manner, with numerous agents involved.
“It’s not being done by small-time operators. These are organized syndicates who are designing to hurt America,” Oz noted.
The DOJ further reports that “29 defendants were charged for their roles in transnational criminal organizations alleged to have submitted over $12 billion in fraudulent claims to America’s health insurance programs.” One organization formed a network foreign straw owners adopted false identities and “strategically bought dozens of medical supply companies located across the United States.”
Another discovery found that the defendants used artificial intelligence to create fake recordings to commit fraud and coerce Medicare beneficiaries into consenting to receive “certain products.” Thereafter, confidential information was sold to laboratories and medical equipment companies in order to submit fake claims to Medicare.
“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,” US Attorney General Pam Bondi said of the investigation findings. “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.”
