Head of the Criminal Division Matthew R. Galeotti Announces Results of Health Care Fraud Takedown

Good morning.

Thank you all for joining us today as we announce the largest coordinated health care fraud takedown in the history of the Department of Justice.

Today marks a decisive moment in our fight to protect American taxpayers from fraudsters and to defend the integrity of our nation’s health care system.

We are announcing charges against 324 defendants for their alleged participation in health care fraud schemes involving approximately $14.6 billion in false claims submitted to Medicare, Medicaid, and other health care programs.

In a takedown this large, I can’t possibly describe all of the work that went into dismantling each scheme, but there are four key points that bear emphasizing.

First, let me be clear about what these health care fraud schemes mean for every hardworking American family: These criminals didn’t just steal someone else’s money — they stole from you.  Every fraudulent claim, every fake billing, every kickback scheme represents money taken directly from the pockets of American taxpayers, who fund these essential programs through their hard work and sacrifice. And when criminals defraud these programs, they’re not just committing theft — they’re driving up our national deficit and threatening the long-term viability of health care for seniors, disabled Americans, and our most vulnerable citizens.

This enforcement action involves the seizure of cash, as well as luxury vehicles and properties, returning real money to American taxpayers and to our government health care programs.

Second, we are seeing a disturbing trend of transnational criminal organizations engaging in increasingly sophisticated and complex criminal schemes that defraud the American health care system.

As part of this takedown, we’ve identified and charged defendants operating from Russia, Eastern Europe, Pakistan, and other foreign countries who have infiltrated our health care system to steal American taxpayer dollars.

As one example, we dismantled a scheme involving a sophisticated operation run from Russia and Eastern Europe that strategically bought dozens of medical supply companies in the United States and submitted more than 10 billion dollars in fraudulent health care claims to Medicare. To make matters worse, these perpetrators used the stolen identities of more than one million Americans, spanning all 50 states, to submit these false claims.

But I’m pleased to report that federal agents intercepted and arrested key members of that organization at U.S. airports and at the U.S.-Mexico border, cutting off their intended escape routes.

The days of transnational criminal organizations using American health care programs as their personal piggy banks are over.

Third, this takedown resulted in criminal charges against 74 defendants, including medical professionals, who fueled America’s deadly opioid epidemic for personal profit. These are not isolated instances of poor judgment. These are calculated schemes designed to exploit Americans struggling with addiction while enriching the very people who were duty-bound to help them heal.

We charged pill mill operators who prescribed unnecessary opioids.  We dismantled networks of corrupt pharmacies that existed solely to distribute drugs to addicts and dealers, feeding the addiction crisis that has devastated so many American communities.

This is not health care; it is a staggering breach of trust.  And under my leadership, the Criminal Division will prosecute these criminals as aggressively as we would prosecute any drug dealer — because that’s exactly what they are.

Fourth, many of the defendants charged as part of this takedown specifically targeted some of our most vulnerable citizens: elderly Americans in nursing homes, individuals with disabilities, those battling serious illnesses, and more.  For example, our prosecutors charged seven defendants, including five medical professionals, in connection with approximately $1 billion in fraudulent claims to Medicare and other health care benefit programs for performing medically unnecessary skin grafts on dying patients as they were seeking to spend their final days with dignity and grace.

That conduct is exactly as callous and disturbing as it sounds. Patients and their families trusted these providers with their lives.  Instead of receiving care, they became victims of elaborate criminal schemes.

Today’s takedown marks a historic day. In addition to the tireless work of our Fraud Section’s Health Care Fraud Unit, this extraordinary effort would not have been possible without the law enforcement agencies with me here today: Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Federal Bureau of Investigation (FBI), Drug Enforcement Administration (DEA).

And of course, countless other partners across the federal, state, and local law enforcement community and dozens of United States Attorneys’ Offices. Thank you to all who made today possible.

Despite these historic achievements, we aren’t resting on our laurels. We’re making advancements to stay ahead of criminals and their illicit schemes.

That is why, today, I am also announcing that we are working with our partners at FBI, HHS-OIG, and other federal agencies to create a Health Care Fraud Data Fusion Center to revolutionize how we detect, investigate, and prosecute health care fraud.  These efforts will be led by the Criminal Division, specifically, the Fraud Section’s Health Care Fraud Unit and comprised of data specialists from the Unit’s Data Analytics Team. The Fusion Center will break down information silos, using coordinated data analysis to enable our investigative teams to quickly identify and dismantle emerging fraud schemes.

This takedown represents the largest health care fraud takedown in American history.

But it’s not the end—it’s the beginning of a new era of aggressive prosecution and data-driven prevention.

Thank you.

I will now turn it over to Acting Inspector General Juliet T. Hodgkins, Department of Health and Human Services Office of Inspector General.