💥HUGE BUST! 324 Defendants Facing Federal Charges, ‘Stolen identities of over 1 million Americans’ (6.30.25) ~ by The Economic Times

In a historic crackdown, the US Department of Justice has announced the 'largest coordinated healthcare fraud bust' in American history. A staggering $14.6 billion in false claims were uncovered, with 324 defendants now facing federal charges across multiple states. At a major press conference, officials from the DOJ, FBI, DEA, and CMS Administrator Dr. Mehmet Oz revealed shocking details of how fraudsters exploited Medicare and Medicaid systems.

SOURCE: https://youtu.be/wsotrYlvL-I

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TRANSCRIPT:

:00
we are announcing today charges against
0:03
324
0:05
defendants for their alleged
0:07
participation in healthc care fraud
0:09
schemes involving approximately $14.6
0:14
billion in false claims submitted to
0:17
Medicare Medicaid and other health care
0:20
programs As part of this takedown we've
0:23
identified and charged defendants
0:24
operating from Russia Eastern Europe
0:27
Pakistan and other foreign countries
0:31
These individuals have infiltrated our
0:33
health care system to steal American
0:35
taxpayer dollars And when I hear about
0:38
this fraud I think about patients who
0:40
have trusted us people who are at their
0:42
most vulnerable time looking for the
0:44
protection uh of our services And too
0:48
often these criminal entities have tried
0:50
to pierce that trust When you walk into
0:52
the Health and Human Services building
0:54
not far from here there's a quote from
0:56
Hubert Humphrey for whom the building is
0:57
named and it says "It is the moral
0:59
obligation of government." That's what
1:01
we're doing here today It's the moral
1:03
obligation of government to protect
1:05
those who are at the dawn of their life
1:07
our children those at the twilight of
1:10
their life our seniors As we announce
1:13
the largest coordinated healthcare fraud
1:15
takedown in the history of the
1:17
Department of Justice
1:19
today marks a decisive moment in our
1:21
fight to protect American taxpayers from
1:24
fraudsters and to defend the integrity
1:28
of America's health care system
1:31
We are announcing today charges against
1:34
324
1:36
defendants for their alleged
1:38
participation in healthc care fraud
1:40
schemes involving approximately
1:43
14.6
1:45
billion dollar in false claims submitted
1:48
to Medicare Medicaid and other healthc
1:51
care programs
1:53
In a takedown this large I can't
1:55
possibly describe all of the work that
1:57
went into dismantling each scheme But
2:00
there are four key points that bear
2:02
emphasizing
2:04
First let me be clear about what these
2:07
healthc care fraud schemes mean for
2:09
every hardworking American family These
2:12
criminals didn't just steal someone
2:14
else's money They stole from you
2:18
Every fraudulent claim every fake
2:21
billing every kickback scheme represents
2:24
money taken directly from the pockets of
2:27
American taxpayers who fund these
2:29
essential programs through their hard
2:31
work and sacrifice
2:34
And when criminals defraud these
2:36
programs they're not just committing
2:38
theft They're driving up our national
2:41
deficit and threatening the long-term
2:43
viability of health care for seniors
2:46
disabled Americans and our most
2:48
vulnerable citizens
2:50
This enforcement action involves a
2:52
seizure of cash as well as luxury
2:54
vehicles and properties returning real
2:57
money to American taxpayers and to our
3:00
government healthcare programs
3:03
Second we are seeing a disturbing trend
3:06
of transnational criminal organizations
3:08
engaging in increasingly sophisticated
3:11
and complex criminal schemes that
3:13
defraud the American health care system
3:16
As part of this takedown we've
3:18
identified and charged defendants
3:19
operating from Russia Eastern Europe
3:22
Pakistan and other foreign countries
3:26
These individuals have infiltrated our
3:28
health care system to steal American
3:30
taxpayer dollars As just one example we
3:34
dismantled a scheme involving a
3:36
sophisticated operation run from Russia
3:38
and Eastern Europe that strategically
3:41
bought dozens of medical supply
3:43
companies in the United States and
3:45
submitted more than $10 billion in
3:48
fraudulent healthcare claims to Medicare
3:51
To make matters worse these perpetrators
3:54
used the stolen identities of more than
3:57
1 million Americans spanning all 50
4:00
states to perpetrate this scheme and
4:02
submit these false claims
4:06
But I'm pleased to report that federal
4:08
agents intercepted and arrested key
4:10
members of that organization at US
4:12
airports and the US Mexico border
4:15
cutting off their intended escape routes
4:19
The days of transnational criminal
4:21
organizations using the American healthc
4:23
care programs as their personal piggy
4:26
bank are over
4:30
Third this takedown resulted in criminal
4:32
charges against 74 defendants including
4:35
medical professionals who fueled
4:37
America's deadly opioid crisis for
4:40
personal profit
4:42
These are not isolated instances of poor
4:45
judgment These are calculated schemes
4:48
designed to exploit Americans struggling
4:50
with addiction while enriching the very
4:53
people who were dutybound to help them
4:55
heal
4:57
We charged pill mill operators who
4:59
prescribed unnecessary opioids We
5:01
dismantled networks of corrupties that
5:04
existed solely to distribute drugs to
5:06
addicts and dealers feeding the
5:09
addiction crisis that has devastated so
5:11
many American communities
5:14
This is not healthcare It is a
5:17
staggering breach of trust And under my
5:20
leadership the criminal division will
5:22
prosecute these criminals as
5:23
aggressively as we would any drug dealer
5:26
because that's exactly what they are
5:30
Fourth many of the defendants charged as
5:33
part of this takedown specifically
5:35
targeted our most vulnerable citizens
5:38
elderly Americans in nursing homes
5:40
individuals with disabilities those
5:43
battling serious serious illnesses and
5:46
more and those living in the shadows
5:49
folks who are having trouble like the
5:50
substance use disorder mentioned a
5:52
second ago by Juliet I want to applaud
5:55
all the agencies that collaborated today
5:58
because when President Trump signed the
5:59
executive order on fraud waste and abuse
6:02
I pledged to crush this reality This is
6:06
exactly what he had in mind At Health
6:08
and Human Services under leadership of
6:09
Secretary Kennedy we have strived to
6:11
break down barriers and silos in every
6:12
way possible What you're witnessing on
6:14
stage today is exactly that the American
6:17
government at its best Making sure all
6:19
of us work together for the same common
6:21
purpose in this case especially
6:23
expressly to protect those who are our
6:25
most vulnerable because all great
6:26
societies are judged by how they take
6:28
care of those who are vulnerable and we
6:30
are great people We will do that So to
6:32
the OIG the DOJ who's hosting us the FBI
6:35
DEA and other agencies that are engaged
6:37
and let me ask uh Kim Kim stand in the
6:40
back Kim Grant runs chief operating
6:42
officer and deputy administrator at CMS
6:44
She runs the fraud unit Uh and I'll
6:47
speak about some of the work she and her
6:48
team have been doing in my comments
6:50
today It is and you'll hear this said by
6:53
all of us and we should the largest the
6:55
largest Department of Justice healthc
6:57
care fraud takedown in history The fact
7:00
that it's impossible that you could have
7:02
15 billion dollars to play in this
7:04
endeavor is it shameful but that's how
7:06
we're being attacked now and it's not
7:07
done by small-time operators as you're
7:10
hearing about and you will read about
7:11
These are organized syndicates who are
7:14
designing to hurt America And why do
7:17
they hurt our health care system well
7:20
CMS is probably the largest target of
7:22
all responsible for about $1.7 trillion
7:24
dollars of dispersements So it's a big
7:26
target on our side And they can pierce
7:29
the veil of protection by just getting
7:31
identifier numbers from our seniors or
7:34
Medicaid recipients or others and thus
7:36
use those tools use you the American
7:38
people to hurt us What we're doing today
7:41
is changing the paradigm Not just going
7:43
after bad guys and putting them behind
7:45
bars but actually getting ahead of these
7:47
schemes so the money never leaves our
7:49
bank account Because by the time we find
7:51
out that these criminals have stolen and
7:53
the money has left the building it's
7:55
already offshore somewhere in some
7:56
foreign country's vaults where foreign
7:58
leaders are rejoicing in the fact they
8:00
took advantage of the American people
8:02
That's why we use the word crushing
8:04
fraud waste and abuse because this is
8:06
not just a nice thing to do in an
8:08
accounting uh pickup that we can you
8:10
know claw back money It doesn't happen
8:12
that easily And this is a modern era
8:14
There are modern tools being used to
8:16
attack us and we need even more modern
8:18
ways including AI which I'll speak about
8:20
in a second to take them down The
8:22
oversight has to be unrelenting We can
8:24
never let our guard down While we're
8:26
sitting in here right now there's
8:28
hundreds of thousands probably millions
8:29
of efforts being made to hack into CMS
8:32
and our system And we have systems
8:34
designed to prevent that to make sure
8:36
the people who need us the most will
8:37
find that we're there to protect them
8:39
The CMS fraud war room that I want to
8:42
announce that Kim is going to lead is an
8:43
effort and example of this It's
8:45
prevented most of the fraudulent efforts
8:48
to take money out of our agency So most
8:51
of the money never left the door So most
8:52
of the money was never stolen even
8:54
though we know you were trying to do it
8:56
And when I speak to you you know when
8:58
the president signed that executive
8:59
order he put a bunch of sheriffs new
9:01
sheriffs in town And that's what you're
9:02
looking at on stage today and many
9:04
others like us who are not going to
9:05
tolerate this anymore We're stopping
9:08
stolen taxpayer money from leaving the
9:10
door stopping it in its tracks Just when
9:12
I was leaving the room today the uh the
9:14
offices today I was hearing about over
9:17
hund00 million that we've stopped from
9:19
leaving the agency just in the fast past
9:22
few weeks There are 27 providers that
9:24
are under active prepayment uh review
9:27
which means we're not going to pay their
9:28
money until we verify that they're
9:31
actually doing their jobs correctly
9:33
There's examples from telemed schemes in
9:35
Florida with clinics billing uh for
9:37
activities that they're not really we
9:39
don't believe providing There's a
9:41
cardiology provider and please help me
9:43
understand this who's providing
9:45
cardiology services in person in Georgia
9:47
and Nevada at the same time on the same
9:50
day Unless teleporting is being made
9:53
feasible not possible But it happens The
9:55
audacity to think you could get away
9:57
with this highlights the fact that folks
9:59
believe they could have taken advantage
10:00
of the agency in the past We're going to
10:02
make sure it doesn't happen again There
10:04
are mental health clinics Listen
10:05
carefully Mental health clinics
10:08
providing sin skin substitute placement
10:11
on their patients Again you're dealing
10:13
with ulcers in a mental health clinic
10:15
These services are provided by an
10:17
anesthesiologist
10:18
Improbable Money is not leaving the
10:20
building You're going to have to prove
10:22
to me that there's a clinical benefit of
10:23
a psychiatrist telling an
10:25
anesthesiologist to put a surgical graft
10:27
on a patient It's not going to happen We
10:30
need your help That's my big plea We
10:32
need your help the American people Why
10:35
over half of the whistleblower uh tips
10:37
that we get are for health care fraud
10:40
and over half of the fraud against our
10:42
government is in healthcare So we need
10:45
your help both to protect your own
10:47
important information Don't give it away
10:49
cuz con artists come to your door and
10:50
try to get it But give us tips You're
10:52
going to hear all of us share
10:54
opportunities that we have but it only
10:56
happens in healthcare because we we know
10:58
we have allies the American people We
11:00
provide care to 68 million Medicare
11:03
beneficiaries 80 million Americans are
11:05
on Medicaid or CHIP There's there's
11:07
another 20 million on the exchanges
11:09
There are a lot of people that will come
11:10
to help us So write this down 1 800HS
11:13
tips 1 800HS tips Uh we have a URL
11:17
obviously if you go to our our website
11:19
as well And I'll leave you with one last
11:20
thought In addition to the massive fraud
11:23
especially from foreign entities trying
11:24
to invade America using their financial
11:27
tools uh and criminal uh mindsets we
11:29
also have 25% of all of our money being
11:33
spent probably subject to abuse Um and
11:36
that's not fraud This is abuse and waste
11:39
money not being used wisely We just
11:41
launched a new model called wiser with
11:43
the Centers for Medicare and Medicaid
11:45
Innovation under Abe Sutton that is
11:47
looking at ways for us to identify
11:50
inappropriate use of services that are
11:53
wasteful and should not be offered to
11:55
the American people because they could
11:56
hurt them and they're certainly not
11:58
providing value for these wonderful
11:59
Americans whose health is being taken
12:02
advantage of to generate higher savings
12:05
higher revenue rather for providers
12:06
We're not going to tolerate it anymore
12:08
We're going to use data analytics real-
12:10
time monitoring and scrupul and and
12:13
unhesitating and unwavering pursuit of
12:15
the law to make sure this happens I want
12:17
to thank my colleagues on the stage and
12:18
their agencies for all the wonderful
12:20
work you have done God bless you