Major Healthcare Fraud Takedown Unveils $6.5B in False Claims

WASHINGTON—The Department of Justice (DOJ) announced the 2026 National Health Care Fraud Takedown results. The takedown operation resulted in charges against 455 defendants, including 90 doctors and other licensed medical professionals for their alleged participation in healthcare fraud schemes involving over $6.5 billion in false claims and significant patient harm, including death. 

The DOJ said takedown operation unveiled cases in 56 federal districts and 45 states and territories of the United States, with 50 state Medicaid Fraud Control Units participating. Officials said it was one of the largest healthcare fraud busts on record in history.

In addition, the DOJ said the two-week takedown resulted in the apprehension and return to the U.S. of the following healthcare fraudsters: one defendant in Kyrenia, Cyprus in connection with an over $3.7 billion durable medical equipment (DME) and urinary catheter scheme; two defendants in Estonia in connection with a previously charged $10.6 billion fraudulent DME Medicare claims scheme; and, in the Philippines, one of FBI’s most wanted fraudsters in connection with a previously-charged $1.2 billion telemedicine fraud scheme. The Most Wanted Fraudsters list features individuals charged with defrauding the American public, specifically targeting schemes involving massive healthcare and pandemic relief fraud.

The takedown also involved the seizure of over $182 million in cash, luxury vehicles, jewelry and other assets.

The department said its enforcement action involves a whole-of-government approach, including:

• Actions by the Centers for Medicare and Medicaid Services (CMS) to suspend 1,079 providers and revoke billing privileges for 1,403 providers.
• Forty-eight civil monetary payment settlements amounting to over $73 million, over 1,400 provider exclusions and 25 actions by the U.S. Department of Health and Human Services, Office of Inspector General under the Civil Monetary Penalties Law seeking more than $10 billion in payments to the Medicare Trust Fund from payments that CMS caught and suspended before the funds were paid to the fraudulent providers.
• Civil charges against 13 defendants for $14.8 million in healthcare fraud schemes, as well as civil settlements with 31 defendants totaling $23 million.
• Nine hundred twenty-eight administrative cases by the Drug Enforcement Administration seeking the revocation of authority to handle and/or prescribe controlled substances since Oct. 1, 2025.

Charges were also filed against 11 defendants, including a company executive and eight medical professionals, across six districts in connection with billions of dollars in fraudulent claims for amniotic wound allografts. In the district of Arizona, the vice president of sales for a company that sold allografts was charged in a nationwide illegal kickback and healthcare fraud scheme where providers billed Medicare over $4 billion for this company’s allografts, resulting in over $2 billion in payments. This significant spike in allograft billings was alleged to have been driven not by medical necessity, but by a kickback scheme, aimed toward elderly people with wounds or on hospice, that generated substantial profit margins and lavish lifestyles for marketers and providers who participated. The company did not manufacture allografts and instead acquired allografts from tissue banks and relabeled them for sale at a 2,000% mark-up, charging up to $1,450 per square centimeter.

“We are aggressively scaling our offensive against anyone using healthcare as a front to steal from the American people,” said Assistant Attorney General Colin M. McDonald of the Justice Department’s national fraud enforcement division. “As today’s cases and arrests show, there is no case too big, no scheme too complex and no hiding place too remote for our relentless fraud-fighting team. Our message is simple: if you put profit over patients, you should expect to be put in prison.”