The results of the 2026 National Health Care Fraud Takedown (the “Takedown”) were announced on June 23, 2026; the Department of Justice (“DOJ”) charged 455 individuals in connection with alleged health care fraud schemes involving over $6.5 billion in false claims. Ninety of the charged individuals were physicians or other medical professionals.
The Takedown, dating back to 2007, is conducted annually by DOJ, the Department of Health and Human Services Office of Inspector General (“HHS-OIG”), the Federal Bureau of Investigation and the Drug Enforcement Administration (“DEA”). This year’s Takedown included participation from Medicaid Fraud Control Units (“MFCUs”) in all 50 states and resulted in cases across 56 federal districts and 45 states and territories, marking the largest coordinated state involvement in the initiative’s history.
The Takedown reflects the Administration’s broader anti-fraud agenda, following the White House’s March 2026 establishment of the Task Force to Eliminate Fraud, and DOJ’s creation of the National Fraud Enforcement Division (“NFED”) to coordinate civil and criminal fraud enforcement. For additional background on the Task Force, see Hall Render’s article here; and for additional background on the NFED, see Hall Render’s article here.
The increased state involvement in this Takedown highlights a shift from a focus on Medicare to a greater emphasis on Medicaid fraud. That shift aligns with broader federal efforts to increase oversight of Medicaid spending and enforcement. It has also increased pressure on states to combat fraud and abuse. In May 2026, HHS-OIG sent a letter to every state attorney general emphasizing each state’s obligation to investigate Medicaid fraud through its MFCU, warning that inadequate enforcement could jeopardize federal funding.
This year’s Takedown is also notable for how authorities identified suspected fraud and where enforcement efforts were concentrated:
- The Health Care Fraud Unit and its new Data Fusion Center used real-time analytics to identify suspicious billing patterns far earlier than in prior years, allowing prosecutors to open an investigation within days of the financial intelligence review.
- Amniotic wound allografts received significant scrutiny after claims data revealed a sharp increase in reimbursement claims, prompting a nationwide investigation.
- Patient safety remains a key enforcement priority. In the Southern District of Florida, for example, defendants allegedly billed $89 million for medically unnecessary cardiovascular testing performed on student athletes, allegedly resulting in patient harm.
- In coordination with the DEA, prosecutors continued to target the unlawful diversion and distribution of controlled substances.
Practical Takeaways
- Expect continued enforcement focused on Medicaid fraud. DOJ has made Medicaid fraud a priority by expanding enforcement resources and increasing coordination with state MFCUs. When providers self-identify potential non-compliance, they should make corrections quickly and complete ongoing monitoring to ensure compliance.
- Assume that fraud detection timelines will continue to decrease. New data analytics tools, including DOJ’s Data Fusion Center, allow regulators to identify suspicious billing patterns and initiate investigations more quickly than in the past. Providers should consider investing in their own internal data-analytics tools to help detect aberrant billing practices.
- Reinforce compliance and billing review processes now. Providers should pay particular attention to rapidly growing reimbursement categories, documentation practices and billing trends that may attract heightened scrutiny from federal and state regulators. A comprehensive compliance program will help prevent providers from engaging in improper billing practices.
If you have questions or would like more information about this topic, please contact:
- Brandon Helms at (248) 457-7847 or bhelms@hallrender.com;
- Katherine Kuchan at (414) 721-0479 or kkuchan@hallrender.com;
- Kaitlin Nucci at (248) 457-7838 or knucci@hallrender.com;
- Kennedy Bunch at (317) 977-1420 or kbunch@hallrender.com; or
- Your primary Hall Render contact.
Special thanks to Summer Associate Stuti Desai for her assistance with the preparation of this article.
Hall Render blog posts and articles are intended for informational purposes only. For ethical reasons, Hall Render attorneys cannot—outside of an attorney-client relationship—answer specific questions that would be legal advice.
