DOJ charges 324 individuals in historic health care fraud indictment.

On June 30, 2025, the U.S. Department of Justice (DOJ), in coordination with the FBI, DEA, HHS–OIG, and more, brought criminal charges against 324 individuals—including 93–96 licensed medical professionals—accusing them of orchestrating fraudulent schemes that targeted federal healthcare programs like Medicare and Medicaid. Those cases include federal criminal charges in the District of Connecticut and the Southern and Eastern Districts of New York, among other courts.

Scope and Impact

• Alleged losses: Over $14.6 billion in false claims, with $2.9 billion confirmed loss to government programs  .
• Assets seized: $245 million in cash, luxury vehicles, cryptocurrency, and real estate  .
• Schemes exposed:
  • Operation Gold Rush: $10.6 billion scheme using shell supply companies and stolen identities to bill for medical supplies (e.g., urinary catheters)  .
  • Opioid “pill mills”: 44 professionals allegedly prescribed over 15 million opioid pills improperly  .
  • Telehealth/genetic testing fraud: $1.17 billion in fraudulent telehealth and lab claims  .
  • COVID testing scams: $293 million in false COVID-19 test reimbursements  .
  • Unnecessary wound care & hospice billing: Examples include $87 million hospice fraud in Texas and $900 million wound-graft schemes in Arizona.

Alleged Criminal Statutes

The Indictments rely on multiple federal statutes, including:

1. Health Care Fraud (18 USC § 1347)
   • Prohibits schemes to defraud any health care benefit program.
   • Penalties: up to 10 years imprisonment; if serious bodily injury occurs, up to 20 years; any term of years to life if death results  .
2. Wire Fraud & Mail Fraud (18 USC §§ 1341, 1343)
   • Target schemes using electronic or postal systems to defraud, charged in cases like telehealth and medical supply fraud.
3. Conspiracy to Commit Health Care Fraud (18 USC § 1349)
   • Covers planning or attempt to commit health care fraud, often charged alongside substantive offenses.
4. False Statements Relating to Health Care (18 USC § 1035)
   • Addresses false or misleading certifications in health care submissions.
5. AKS–Linked False Claims
   • Under False Claims Act and Anti‑Kickback Statute, claims tainted by illicit payments become false claims  .
6. Money Laundering (18 USC §§ 1956, 1957)
   • Alleged in cases involving laundering of illicit proceeds (e.g., COVID lab reimbursements) ().
7. Controlled Substances Violations (21 USC § 841)
   • Charged against those prescribing or distributing opioids without medical justification ().

Potential Criminal Penalties

Persons convicted under these statutes face significant consequences:

• Health Care Fraud (18 USC § 1347):
  • Up to 10 years in prison, fines up to $250,000 (individuals) or $500,000 (organizations).
  • If serious injury: up to 20 years.
  • If death results: up to life imprisonment  .
• Wire/Mail Fraud (18 USC §§ 1341, 1343):
  • Up to 20 years imprisonment (30 years if federally funded program affected).
  • Fines up to $250,000 (individual), $500,000 (organization).
• Conspiracy (18 USC § 1349):
  • Equivalent penalties to the underlying crime.
• False Statements (18 USC § 1035):
  • Up to 5 years imprisonment.
• Money Laundering (18 USC § 1956/57):
  • Up to 20 years imprisonment; potential mandatory asset forfeiture.
• Controlled Substance Distribution (21 USC § 841):
  • Varies—could range from 5 years to life, particularly with death or addiction consequences.
• False Claims Act liability:
  • Civil, but can lead to treble damages plus $11,665–$23,331 per false claim; whistleblowers can receive 15–30% of recoveries  .

In Summary

This unprecedented DOJ action marks the largest single-day health care fraud indictment in U.S. history:

• 324 defendants spanning medical professionals and criminal networks.
• $14.6 billion in intended billing; $2.9 billion confirmed losses.
• Schemes included opioid pill mills, telehealth, fraudulent supplies, COVID testing, hospice, and genetic testing.
• Charges include health care fraud, wire/mail fraud, conspiracy, false statements, money laundering, and controlled substance violations.
• Convictions may bring decades behind bars, hefty fines, restitution, and forfeiture.

This operation—dubbed the “2025 National Health Care Fraud Takedown” and part of “Operation Gold Rush”—headlined by high-level prosecutors, accuses a staggering number of people of various frauds against health care programs and allegedly vulnerable patients.

Matthew Galluzzo is a federal criminal defense attorney practicing in New York and Connecticut federal courts. A former Manhattan prosecutor, he has successfully represented numerous individuals accused of federal health care fraud crimes and wire fraud charges. If you or a loved one have been accused as part of Operation Gold Rush or the 2025 National Health Care Fraud Takedown, you should strongly consider contacting Mr. Galluzzo to discuss his legal services.