The largest $15 billion healthcare fraud has been stopped in the US

The possible criminal scheme in the US Department of Justice has been called the largest in the healthcare sector in the history of the department. The suspects include people from Estonia, Kazakhstan and Russia. They are charged with conspiracy, healthcare fraud and money laundering.

The investigation uncovered a scheme in which the perpetrators allegedly acquired more than 30 small health care supply companies that were already registered with Medicare. Through the legal entities, the fraudsters exploited loopholes in the reimbursement system and filed massive false insurance claims for medical products that they allegedly purchased and provided to patients. The total amount of funds requested from the national system amounted to more than $10.6 billion.

For example, since the end of 2022, the companies have collectively filed documents with Medicare about 1 billion urinary catheters given to insured Americans, according to the Justice Department. “I don’t even know if the United States has the capacity to make a billion catheters in such a short time. The absurdity, the audacity of these actors is truly astounding,” said Isaac Bledsoe, director of strategic projects and initiatives in the Office of the Inspector General of the U.S. Department of Health and Human Services.

Federal officials were able to prevent the alleged criminals from receiving more than 99 percent of the payments from Medicare, but the defendants were still able to collect about $1 billion in payments from other insurance companies that work with the main national system. To forge documents, the criminals used the data of more than 7,000 doctors without their knowledge.

In addition, the US Department of Justice reported the closure of other alleged health care fraud schemes totaling $4 billion. These violations are related to telemedicine, genetic testing and opioid trafficking.