“These criminals didn’t just steal someone else’s money. They stole from you," Matthew Galeotti, who leads the Justice Department’s criminal division, told reporters Monday. “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."
The alleged $14.6 billion in fraud is more than twice the previous record in the Justice Department’s annual health care fraud crackdown. It includes nearly 190 federal cases and more than 90 state cases that have been charged or unsealed since June 9. Nearly 100 licensed medical professionals were charged, including 25 doctors, and the government reported $2.9 billion in actual losses.
Among the cases is a $10 billion urinary catheter scheme that authorities say highlights the increasingly sophisticated methods used by transnational criminal organizations. Authorities say the group behind the scheme used foreign straw owners to secretly buy up dozens of medical supply companies and then used stolen identities and confidential health data to file fake Medicare claims.
Nineteen defendants have been charged as part of that investigation — which authorities dubbed Operation Gold Rush — including four people arrested in Estonia and seven people arrested at U.S. airports and at the border with Mexico, prosecutors said. The scheme involved the stolen identities and personal information of more one million Americans, according to the Justice Department.
"It's not done by small time operators," said Dr. Mehmet Oz, who leads the Centers for Medicare and Medicaid Services. "These are organized syndicates who are designing to hurt America."
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This story has been updated to show the Justice Department alleges the scheme resulted in nearly $15 billion in false claims.