National Health Care Fraud Takedown Charges 455 Defendants in $6.5 Billion Scheme

The Justice Department has announced the 2026 National Health Care Fraud Takedown, charging 455 defendants—including 90 doctors and other licensed medical professionals—with schemes involving over $6.5 billion in false claims. The operation represents the largest coordinated enforcement action in Department history, spanning 56 federal districts across 45 states and territories with 50 state Medicaid Fraud Control Units participating.

A significant portion of the takedown targeted fraudulent wound care schemes involving amniotic allografts. In one case, a sales executive allegedly orchestrated a nationwide kickback scheme that drove over $4 billion in Medicare billings for allografts—tissue products acquired for as little as $72 per square centimeter and resold at up to $1,450, a markup exceeding 2,000%. The executive allegedly paid illegal kickbacks of approximately 40% of that amount, enabling marketers and medical providers to pocket $500-600 per square centimeter. The scheme allegedly targeted hospice patients and applied allografts to superficial wounds that did not need treatment, without proper coordination with treating physicians. The defendant allegedly received over $24 million from the company, which he used to purchase luxury homes, million-dollar life insurance policies, and a $135,000 Maserati.

In another case, a nurse practitioner in Texas was charged with a $906 million scheme in which she applied medically unnecessary allografts and billed Medicare more than $1 million per patient on average. The government seized over $30 million in assets, including a $594,000 Ferrari, a custom Bulgari necklace valued at $865,000, and other luxury items. The takedown also included civil charges against 13 defendants and civil settlements with 31 defendants totaling $23 million, along with over 1,400 provider exclusions. This case reflects the government’s unprecedented use of advanced data analytics and international cooperation to pursue healthcare fraud at every level—from doctors’ offices to corporate boardrooms.