The Department of Justice charged 455 defendants on June 23, 2026, in the 2026 National Health Care Fraud Takedown, marking a record enforcement action involving over $6.5 billion in alleged false claims across health care fraud and opioid abuse schemes.
The takedown represents an escalation from the prior year: the 2025 action charged 324 defendants in connection with over $14.6 billion in alleged fraud. This year’s operation, while charging more defendants, reflects a shift in enforcement strategy toward broader geographic participation and data-driven targeting of specific fraud schemes.
Among the 455 defendants, 90 were doctors and other licensed medical professionals. The charges span 56 federal districts and involve 45 U.S. states and territories, with 50 state Medicaid Fraud Control Units participating—the most in Department history, according to the DOJ announcement.
Medicaid fraud emerged as a major focus. The takedown included charges against 295 defendants for Medicaid fraud involving over $518 million in alleged false claims, making it the largest Medicaid fraud enforcement action in DOJ history. Schemes targeted vulnerable populations: in the Eastern District of New York, eight defendants were charged for a $38 million fraud on New York Medicaid for social adult day care services that were never provided, with defendants falsely billing for hundreds of beneficiaries per day at facilities with occupancy limits of 30 people.
Fraudulent wound care schemes drew particular attention. Eleven defendants, including a company executive and eight medical professionals, faced charges in connection with billions of dollars in fraudulent claims for amniotic wound allografts. One nurse practitioner in the Southern District of Texas was charged with a $906 million scheme involving medically unnecessary allografts, with the government seizing a $594,000 Ferrari, an $865,000 Bulgari necklace, and over $30 million in bank accounts.
The enforcement action leveraged advanced data analytics. The Health Care Fraud Unit’s Data Fusion Center, which combines traditional data analysis with financial intelligence, led investigations into complex schemes. In one case involving alleged Illinois Medicaid fraud, data analysts detected a defendant submitting claims for 500 or more hours of behavioral health services per day—impossible given the number of staff—and opened an investigation within five days. The defendant was arrested less than seven months later attempting to flee the country.
Patient harm cases underscored the stakes. In the Southern District of Florida, a cardiovascular testing medical director was charged in an $89 million scheme involving unnecessary tests on student athletes. Despite knowing students could suffer sudden cardiac death, the defendant allegedly rubber-stamped test results as normal without review, sometimes within seconds. One student athlete with an enlarged heart died from cardiac complications during basketball practice approximately 24 days after the defendant approved the results as normal.
Illegal opioid distribution accounted for 36 defendants, including 28 licensed medical professionals. In the Eastern District of Pennsylvania, three defendants operated a voicemail refill line allowing patients to request Schedule II controlled substance refills without physician interaction. Despite knowing some patients who used the line suffered overdoses and died, the defendants continued the operation.
International cooperation expanded the reach of enforcement. The DOJ apprehended one defendant in Kyrenia in connection with a $3.7 billion scheme, two defendants in Estonia tied to a previously charged $10.6 billion scheme, and one of the FBI’s Most Wanted Fraudsters in the Philippines in connection with a $1.2 billion telemedicine fraud scheme.
The takedown also included civil enforcement: charges against 13 defendants for $14.8 million in health care fraud schemes, civil settlements with 31 defendants totaling $23 million, and 48 Civil Monetary Payment settlements exceeding $73 million. The Centers for Medicare and Medicaid Services suspended 1,079 providers and revoked billing privileges for 1,403 providers.
Sources
- Department of Justice — Official press release announcing 455 defendants charged, $6.5 billion in alleged fraud, participant states, Medicaid fraud figures, wound care scheme details, patient harm cases, opioid distribution charges, international apprehensions, and civil enforcement actions.
- Eye on Enforcement — Confirmed 455 defendants charged, 90 doctors included, $6.5 billion in alleged fraud, and 295 Medicaid fraud defendants with $518 million in false claims.
- Arnold & Porter — Confirmed record-breaking nature of takedown, largest Medicaid fraud enforcement action in DOJ history, and data-driven enforcement approach.
- The Hill — Confirmed 450+ defendants charged in $6.5 billion operation including 90 medical professionals.
