DOJ Dismantles $14 Billion Healthcare Fraud Scheme In Largest-Ever Crackdown, Impacting Over 1 Million Americans
The Department of Justice, more than 320 individuals have been charged, uncovering nearly $15 billion in fraudulent claims, marking a significant milestone in the fight against healthcare fraud.
What Happened: The Justice Department announced the charges on Monday, revealing a staggering $14.6 billion in fraudulent claims. The operation, named “Operation Gold Rush,” also resulted in the seizure of assets worth over $245 million, including cash, luxury vehicles, and cryptocurrency.
The crackdown uncovered perpetrators operating from Russia, Eastern Europe, Pakistan, and several other countries. “These criminals didn't just steal someone else's money. They stole from you,” stated Matthew Galeotti, head of the Justice Department's criminal division.
Approximately 100 licensed medical professionals, including 25 doctors, have been charged. The government has reported actual losses totaling $2.9 billion. Among the cases is a $10 billion urinary catheter scheme, underscoring the growing sophistication of transnational criminal organizations.
The scheme used stolen identities and personal information of over one million Americans, according to the Justice Department.
The fraud, surpassing the previous record in the Justice Department's annual health care fraud crackdown, involves nearly 190 federal cases and more than 90 state cases that have been charged or unsealed since June 9.
Why It Matters: This crackdown on health care fraud comes months after a civil fraud investigation into UnitedHealth Group Inc.’s (NYSE:UNH) Medicare billing practices by the Justice Department. The probe, which began in recent months, is set to examine UnitedHealth’s Medicare Advantage plans and physician groups following reports that the company received billions in federal payments for questionable diagnoses.
Moreover, this development is in line with the efforts to combat Medicare fraud, as outlined in Rep. Ro Khanna‘s (D-Calif.) “Progressive Deficit Reduction Plan.” The plan, which was backed by billionaire investor Mark Cuban, aims to slash the U.S. deficit by $12 trillion over the next decade, with a significant portion of the spending cuts targeted at Medicare fraud.
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