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The Department of Justice has announced one of the largest health care fraud enforcement actions in US history, charging 324 individuals (including nearly 100 licensed medical professionals) in schemes involving billions of dollars in losses across all states.

Getting into it: According to the DOJ, the 2025 National Health Care Fraud Takedown uncovered $14.6 billion in intended losses to Medicare, Medicaid, and other public health programs, with actual confirmed losses totaling at least $2.9 billion. This sweeping crackdown targeted a wide spectrum of criminal activity — ranging from massive international fraud rings to localized schemes that exploited the most vulnerable members of society. Federal agents seized over $245 million in cash, luxury goods, cryptocurrencies, and other assets believed to be purchased with illicit gains. Additionally, the Centers for Medicare and Medicaid Services successfully blocked $4 billion in fraudulent payments before they were disbursed and suspended or revoked the billing privileges of over 200 providers.

Among the most disturbing cases revealed in the takedown was a $1.1 billion fraudulent wound care scheme that specifically targeted elderly and hospice patients. Charges were filed against seven individuals, including five licensed medical professionals, in Arizona and Nevada. These defendants allegedly exploited Medicare by billing for costly amniotic wound grafts under the pretense that they were medically necessary. In reality, the grafts were often applied to superficial wounds or used on patients who did not need them. Prosecutors say that many of these patients were in hospice or receiving end-of-life care, making them especially vulnerable to this abuse.

In some cases, they conducted procedures without proper infection control, failed to treat underlying medical conditions, or performed redundant applications of these expensive treatments simply to inflate billing volumes. Many procedures were carried out without any legitimate medical assessment, and in certain instances, the treatment areas were far larger than the actual size of the wounds, further maximizing reimbursement claims. Investigators also uncovered that millions of dollars were paid in illegal kickbacks to medical professionals and marketers in exchange for referring patients into the fraudulent billing cycle.

In addition to the wound care scheme, the DOJ uncovered a network of prescription opioid trafficking involving 74 defendants (44 of whom were licensed medical professionals) accused of illegally distributing over 15 million pills. These cases spread across 58 indictments, revealed how doctors, pharmacists, and pharmacy owners abused their positions to flood communities with powerful narcotics like oxycodone. In one major case, a pharmacy in Texas was allegedly responsible for distributing more than 3 million opioid pills, which were funneled to street-level dealers for massive profits.

US officials react: In a statement, FBI Director Kash Patel said, “Health care fraud drains critical resources from programs intended to help people who truly need medical care. Today’s announcement demonstrates our commitment to pursuing those who exploit the system for personal gain. With more than $13 billion in fraud uncovered, this is the largest takedown for this initiative to date. Together, the FBI and our law enforcement partners will continue to hold those accountable who steal from the American people and undermine our health care systems.”

Attorney General Pam Bondi: “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.”

HHS Secretary Robert F. Kennedy Jr.: “As part of making healthcare accessible and affordable to all Americans, HHS will aggressively work with our law enforcement partners to eliminate the pervasive health care fraud that has bedeviled this agency under the former administration and drove up costs.”