On June 30, 2025, the Department of Justice (“DOJ”) announced that it was combating over $14.6 billion in alleged fraud as a result of the 2025 National Health Care Fraud Takedown (“Takedown”). The Takedown is a coordinated effort led by the Health Care Fraud Unit of the DOJ Criminal Division’s Fraud section, partnering with U.S. Attorneys’ Offices, the Department of Health and Human Services Office of Inspector General (“HHS-OIG”), the Federal Bureau of Investigation (“FBI”) and the Drug Enforcement Agency (“DEA”). The Takedown resulted in criminal charges against 324 defendants across 50 federal districts and 12 State Attorneys General’s offices. Surpassing the previous record of $6 billion, the 2025 Takedown demonstrates the government’s continued targeting of health care fraud. While the Takedown focuses on criminal prosecutions, the criminal actions can and often do lead to civil False Claims Act (“FCA”) investigations against the criminal defendants or against providers that may be in some way associated with the criminal defendants like hospitals, durable medical equipment companies, skilled nursing facilities and home health care companies.
As stated by Acting Inspector General Juliet T. Hodgkins of HHS-OIG, “[t]he scale of today’s Takedown is unprecedented, and so is the harm we’re confronting. Individuals who attempt to steal from the federal health care system and put vulnerable patients at risk will be held accountable.” FBI Director Kash Patel added, “[t]oday’s announcement demonstrates our commitment to pursuing those who exploit the system for personal gain. With more than $14 billion in fraud uncovered, this is the largest takedown for this initiative to date. Together, the FBI and our law enforcement partners will continue to hold those accountable who steal from the American people and undermine our health care systems.”
The Takedown’s priorities include:
- Telemedicine and Genetic Testing Fraud: 49 individuals were charged in connection with over $1.17 billion in alleged fraudulent claims submitted to Medicare for telemedicine and genetic testing schemes. In one case in the Southern District of Florida, a telemedicine and durable medical equipment company owner was charged in a $46 million scheme involving deceptive telemarketing tactics used to target Medicare beneficiaries, followed by fraudulent claims for genetic tests and medical equipment.
- Prescription Opioid Trafficking: 74 individuals, including 44 licensed medical professionals, were charged in 58 cases involving the illegal diversion of more than 15 million opioid pills and other controlled substances. In one case, five individuals linked to a Texas pharmacy were charged with distributing over three million opioid pills, which were allegedly sold by street-level dealers for significant profit. This action reflects the Health Care Fraud Unit’s ongoing strategy to dismantle drug trafficking networks and their pharmaceutical suppliers. Additionally, the DEA announced 93 administrative actions over the past six months seeking to revoke the ability of pharmacies, prescribers and companies to handle controlled substances.
- False Claims. In addition to the other charges, 170 defendants were charged in cases involving over $1.84 billion in alleged false claims submitted to Medicare, Medicaid and private insurers. These schemes involved billing for medically unnecessary services, kickbacks and bribes, or services that were never provided.
Health Care Fraud Data Fusion Center Announcement
As part of a coordinated nationwide enforcement effort, DOJ announced that it is partnering with HHS-OIG, the FBI and other agencies to launch a Health Care Fraud Data Fusion Center. This initiative will combine expertise from DOJ’s Criminal Division, including its Health Care Fraud Unit’s Data Analytics Team (established in 2018), along with data specialists from partner agencies. By leveraging cloud computing, AI and advanced analytics, the Center aims to more effectively detect, investigate and prosecute emerging health care fraud schemes. It also supports the President’s Executive Order to eliminate information silos (Exec. Order No. 14243) by reducing redundant data teams, streamlining operations and promoting a unified, government-wide approach to combating fraud.
Practical Takeaways
The Takedown highlights the government’s aggressive and evolving approach to health care fraud enforcement. With over $14.6 billion in alleged fraud uncovered and charges brought against 324 defendants across 50 federal districts and 12 State Attorneys General’s Offices, the Takedown signals that enforcement is expanding not only in scope but also in sophistication.
Key enforcement areas, including telemedicine, prescription opioid diversion and false claims, underscore the government’s focus on high-impact schemes that both exploit public programs and endanger patient safety. The announcement of the new Health Care Fraud Data Fusion Center further reflects DOJ’s intent to enhance detection capabilities using AI, cloud computing and cross-agency collaboration, as it shifts toward a data-driven, proactive enforcement model.
Moreover, these criminal indictments will surely lead to civil FCA actions. For health care providers and companies, this means that internally driven proactive compliance efforts are more critical than ever, particularly for providers who received any referrals from indicted individuals. Internal investigations should be conducted to assess potential exposure and to reduce or eliminate operational disruptions and reputational harm.
For help understanding your legal obligations, assessing your potential compliance risks or internally investigating a potential issue, please contact:
- Scott Taebel at (414) 721-0445 or staebel@hallrender.com;
- Brandon Helms at (248) 457-7847 or bhelms@hallrender.com; or
- Your primary Hall Render contact.
Special thanks to Summer Associate Wyatt Poer for his assistance with this article.
Hall Render blog posts and articles are intended for informational purposes only. For ethical reasons, Hall Render attorneys cannot give legal advice outside of an attorney-client relationship.
