The Justice Department on Tuesday announced charges against roughly 450 defendants in what officials described as the largest coordinated healthcare fraud crackdown in the department’s history. The alleged schemes total more than $6.5 billion in fraudulent claims, with operations spanning 57 federal court districts and 41 states and territories.
The sweep includes charges against 90 medical professionals and a record number of Medicaid fraud defendants, with more than 100 people accused of submitting over $100 million in false Medicaid claims. Federal officials said 46 state Medicaid Fraud Control Units participated in the operation, which also resulted in the seizure of more than $127 million in cash, luxury vehicles, jewelry and other assets.
One of the highest-profile cases involves Oren David Shachar, the owner of several healthcare businesses in the Los Angeles area, including at least four hospices. According to an indictment, prosecutors allege that Shachar paid kickbacks and bribes to enroll people who were not terminally ill in hospice care, resulting in nearly $27.7 million in fraudulent Medicare claims. Medicare paid about $26.9 million of that amount, according to the indictment.
The indictment further alleges that Shachar’s scheme included enrolling deceased Medicare beneficiaries in hospice after their deaths, using stolen personal information obtained through a funeral home employee, and creating backdated medical records to make it appear the patients had qualified for hospice before they died. Prosecutors also said Shachar personally approached Medicare beneficiaries, misrepresenting hospice as a program focused on improving quality of life rather than end-of-life care, and concealed that enrolling would limit their access to other Medicare-covered treatments. He allegedly paid beneficiaries up to $400 a month in cash and provided groceries, alcohol, televisions, furniture and other gifts to keep them enrolled, and offered referral payments to beneficiaries who recruited others into the program.
A lawyer for Shachar, who has pleaded not guilty in the case, did not return a request for comment.
Jacob Foster, acting chief of the Justice Department’s Health Care Fraud Unit, described the Los Angeles case as illustrative of complex fraud schemes the department is trying to catch earlier. “This was a concerted effort to stay under the radar, and it indicates the cat-and-mouse game that we’re involved in,” Foster said.
The Trump administration has intensified its focus on government waste while launching what it calls a “war on fraud.” Democratic critics have argued that some of the administration’s efforts are politically motivated attempts to target blue states and programs conservatives have sought to cut, such as Medicaid, the joint federal-state health coverage program for low-income Americans.
Alongside the charges, the Justice Department unveiled a series of new data-sharing agreements designed to expand access to fraud-related information. Memorandums of understanding with the Federal Trade Commission will give prosecutors access to consumer-complaint data relevant to telemarketing and telemedicine scams. An agreement with the Department of Homeland Security provides travel information to help identify providers billing for services while they are physically outside their clinics.
The Justice Department also announced an agreement with the Centers for Medicare and Medicaid Services that gives prosecutors access to CMS’s fraud-detection system, which uses machine learning to identify suspicious billing by healthcare providers. Officials said the tool is already helping investigators spot potential fraud faster and send cases to specialized teams that analyze emerging fraud trends.