Biggest health care fraud crackdown in U.S. history targets $14.6B in alleged scams

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In a move federal officials called “unprecedented,” the U.S. Department of Justice (DOJ) on Monday announced charges against 324 individuals — including 96 doctors, nurse practitioners, pharmacists and other licensed medical professionals — in connection with over $14.6 billion in alleged fraud schemes against federal health programs. The 2025 National Health Care Fraud Takedown, led by the DOJ’s Health Care Fraud Unit, spanned 50 federal districts and included civil and criminal charges across a wide range of fraud schemes.

Pamela Bondi, U.S. attorney general © flgov.com

“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,” said U.S. Attorney General Pamela Bondi.

The following cases are spotlighted not only for their scale, but because they reflect broader patterns in the evolution of health care fraud — international in reach, highly sophisticated in execution and devastating in its targeting of vulnerable populations.

Transnational crime and catheter claims

Among the largest cases unveiled was “Operation Gold Rush,” a transnational scheme involving over $10.6 billion in fraudulent Medicare claims for urinary catheters and other durable medical equipment (DME). DOJ prosecutors said foreign actors created a network of sham supply companies in the U.S. using stolen identities from more than one million Americans. These companies rapidly submitted fraudulent claims, often without patient contact, and laundered proceeds via cryptocurrency and shell companies overseas.

Nineteen individuals were charged, including 12 arrests. Four were apprehended in Estonia and seven at U.S. airports or the U.S.-Mexico border. One U.S.-based banker was charged for laundering proceeds through a domestic institution.

While $4.45 billion in fraudulent claims were initially flagged for payment, the U.S. Centers for Medicare & Medicaid Services (CMS) blocked all but $41 million from being disbursed. Roughly $900 million was still paid out by Medicare supplemental insurers. Authorities seized $27.7 million in fraud proceeds.

Arizona addiction treatment scam and wound care fraud

In the District of Arizona, prosecutors charged Farrukh Jarar Ali, a billing company executive based in Pakistan and the UAE, for allegedly orchestrating a $650 million Medicaid fraud scheme involving at least 41 Arizona substance abuse treatment centers. According to court filings, some services were not provided, while others were so substandard they lacked any therapeutic value. Patients were recruited from Native American reservations and the homeless population in exchange for kickbacks.

Ali allegedly received $24.5 million in proceeds, some of which was used to purchase a $2.9 million golf estate property in Dubai.

In a separate Arizona case, nurse practitioner Ira Denny is accused of submitting nearly $209.4 million in fraudulent Medicare claims for amniotic wound allografts applied without medical necessity. Denny allegedly followed directions from sales reps with no medical training. Medicare paid more than $138.6 million in claims related to the scheme.

Tyler Kontos, Joel “Max” Kupetz and Jorge Kinds were also charged in a related $1 billion wound care fraud scheme. The trio allegedly laundered fraud proceeds through luxury purchases and cryptocurrency. Prosecutors have seized over $7.2 million in assets to date.

Veterans affairs and DME fraud

The takedown also included cases involving fraud against veterans and federal employee health programs. In South Carolina, Tina Marie Armstrong was indicted for billing nearly $199,000 to Medicare and Medicaid for DME that was not delivered or authorized. She received approximately $104,600 in improper payments.

In Tennessee, three defendants were charged with billing $28.7 million to the Federal Employees’ Compensation Fund for drugs not prescribed or dispensed.

In a separate case, massage therapist Dee Alice Moton allegedly billed the Department of Veterans Affairs (VA) over $2.37 million for services that were never provided to disabled veterans.

Kickbacks, ghost patients and AI-generated consent

In another major case, this time spanning Illinois and Pakistan, five individuals were charged in a $703 million fraud in which Medicare beneficiaries’ personal information was allegedly obtained through theft and deceptive advertising, then sold to DME companies and labs.

As part of the scheme, artificial intelligence (AI) was reportedly used to create fake audio recordings of patients purportedly consenting to services. The scheme included 70 nominee-owned companies and extensive laundering operations.

Robert Murphy, acting administrator, DEA © DEA.gov

Prescription opioids and telehealth schemes

The takedown also targeted opioid trafficking and distribution rings, charging 74 defendants across 58 separate cases of illegally distributing over 15 million pills. One Texas-based operation was linked to more than 3 million illicit doses of oxycodone, hydrocodone and carisoprodol. The Drug Enforcement Administration (DEA) also initiated 93 administrative actions to revoke controlled substance handling privileges.

“Health care fraud isn’t just theft — it’s trafficking in trust,” said Robert Murphy, acting administrator of the DEA. “We’re targeting the entire ecosystem of fraud — from pill mills in Texas to kickback clinics exploiting Native communities.”

Additionally, 49 defendants were charged in $1.17 billion in fraudulent telehealth and genetic testing claims. In one Florida case, a telehealth and DME company owner was charged in a $46 million fraud involving deceptive telemarketing and billing for unnecessary tests and devices.

CMS Administrator Mehmet Oz, M.D., MBA, said the agency’s real-time analytics and fraud prevention tools prevented more than $4 billion in improper payments ahead of the takedown. “We’re not waiting for fraud to happen — we’re stopping it before it starts,” Oz said.

Mehmet Oz, M.D., MBA, administrator, CMS © CMS.gov

A coordinated federal push

The 2025 Takedown marks the largest coordinated enforcement action in the history of the DOJ’s Health Care Fraud Strike Force — more than doubling the previous $6 billion record. It involved the DOJ, Federal Bureau of Investigation (FBI), Health and Human Services Office of Inspector General (HHS-OIG), DEA, CMS and 12 State Attorneys General Offices.

The operation also unveiled a new Health Care Fraud Data Fusion Center, designed to merge resources across agencies using AI, cloud computing and shared analytics platforms. The center is part of President Trump’s Executive Order on eliminating data silos across federal enforcement bodies.

Civil enforcement actions included charges against 20 defendants involving $14.2 million in alleged fraud and settlements with 106 defendants totaling $34.3 million. In total, the government seized $245 million cash, luxury items, cryptocurrency and other assets.

Looking ahead

The DOJ emphasized that law enforcement will continue to scale alongside emerging threats, including digital fraud and international networks. As of June 2025, the Health Care Fraud Strike Force has charged more than 5,400 defendants since 2007, collectively accused of billing over $27 billion.

For more information, find individual case descriptions here, and find publicly available court documents here.

All indictments are allegations, and all defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.