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DOJ Launches AI-Driven War Rooms After Record $14.6B Healthcare Fraud Bust

It is designed to protect taxpayer-funded programs by catching fraud before claims are paid.

FILE - The U.S. Department of Justice logo is seen on a podium before a press conference with Attorney General Pam Bondi, May 6, 2025, at the Justice Department in Washington. (AP Photo/Julia Demaree Nikhinson, File)
Dr. Mehmet Oz, administrator for the Centers for Medicare & Medicaid Services, listens as Matthew R. Galeotti, head of the Justice Department’s Criminal Division, speaks about a healthcare fraud enforcement action during a press conference at the U.S. Department of Justice in Washington, D.C., U.S., June 30, 2025. REUTERS/Kevin Lamarque
Stock photo of nurse preparing an injection in a pediatric center.
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Overview

  • The Justice Department charged 324 defendants nationwide, with prosecutions split between 77 state cases and 247 federal indictments targeting schemes against Medicare and Medicaid.
  • Law enforcement seized over $245 million in cash, luxury vehicles, cryptocurrency and other assets tied to the sprawling fraud networks.
  • The Centers for Medicare & Medicaid Services blocked more than $4 billion in suspect payouts and revoked billing privileges for 205 providers in the lead-up to the operation.
  • Nearly 100 licensed medical professionals face charges, including allegations of prescribing unnecessary treatments to vulnerable groups such as Native American and homeless patients.
  • DOJ and CMS have set up AI-driven fraud war rooms complemented by expanded prepayment reviews to spot and halt dubious billing before taxpayer funds are disbursed.