In what officials are calling the largest coordinated health care fraud enforcement action in American history, the Department of Justice has successfully leveraged artificial intelligence and data analytics to uncover an astonishing $14.6 billion in fraudulent healthcare schemes.
The 2025 National Health Care Fraud Takedown resulted in criminal charges against 324 defendants, including 96 licensed medical professionals across 50 federal districts and 12 State Attorneys General's Offices. Law enforcement seized over $245 million in assets including cash, luxury vehicles, and cryptocurrency as part of the operation.
Central to this success was the debut of the Health Care Fraud Data Fusion Center, a multi-agency initiative that brings together experts from the DOJ's Criminal Division, HHS-OIG, and FBI. The center utilizes cloud computing, artificial intelligence, and advanced analytics to identify emerging healthcare fraud schemes, marking a strategic shift from reactive investigation to proactive detection.
"These criminals didn't just steal someone else's money. They stole from you," said Matthew Galeotti, who leads the Justice Department's criminal division. "Every fraudulent claim, every fake billing, every kickback scheme represents money taken directly from the pockets of American taxpayers."
The centerpiece of the operation, dubbed "Operation Gold Rush," exposed a transnational catheter supply fraud led by Russian and Eastern European criminal networks. Using advanced data mining techniques, authorities identified suspicious patterns—such as DME suppliers sending thousands of catheters to nonexistent addresses—and deployed enforcement teams accordingly.
The Centers for Medicare and Medicaid Services also prevented over $4 billion in fraudulent claims from being paid and suspended the billing privileges of 205 providers. "We're not waiting for fraud to happen—we're stopping it before it starts," stated CMS Administrator Dr. Mehmet Oz.