DOJ Charges 455 in 2026 National Health Care Fraud Takedown, Alleging $6.5 Billion in False Claims

The Justice Department said Tuesday that its 2026 National Health Care Fraud Takedown charged 455 defendants in alleged schemes involving more than $6.5 billion in false claims, marking one of the largest nationwide enforcement sweeps the department has announced in the sector.

According to DOJ, those charged include 90 doctors and other licensed medical professionals. The cases were brought in 56 federal districts across 45 states and territories and involved alleged conduct that caused “significant patient harm, including death.” DOJ also said all 50 state Medicaid Fraud Control Units took part, which it described as the most in department history. The sweep is part of the department’s recurring nationwide health care fraud crackdown tied to its long-running Health Care Fraud Strike Force program.

The department also emphasized the unusually broad reach of this year’s operation. DOJ said it secured international apprehensions and returns to the United States, including one defendant in Kyrenia tied to an alleged scheme involving more than $3.7 billion, two defendants in Estonia tied to a previously charged $10.6 billion scheme, and one defendant in the Philippines tied to a previously charged $1.2 billion telemedicine fraud case. Authorities also seized more than $182 million in cash, vehicles, jewelry and other assets, DOJ said. In parallel administrative actions, the Centers for Medicare & Medicaid Services, the federal agency that runs Medicare and Medicaid, said it suspended 1,079 providers and revoked billing privileges for 1,403 providers.

One of the clearest examples outlined by DOJ involved billing for amniotic wound allografts, tissue products used in wound care. DOJ said it charged 11 defendants, including company executives and medical professionals, in alleged schemes involving those products. According to DOJ, providers billed Medicare more than $4 billion for one company’s allografts from December 2021 through June 2024, resulting in more than $2 billion in payments.

DOJ alleged the allograft scheme included relabeling tissue, charging steep markups and paying illegal kickbacks. It also said grafts were applied when not medically necessary, including to hospice patients. The case illustrates both the patient-care risks and the potential effect on Medicare spending that prosecutors say can accompany fraud allegations of this scale.

DOJ said CMS responded by realigning payment for certain allografts to $127 per square centimeter, effective Jan. 1, 2026. According to DOJ, without that change, the spike in allograft billing would have raised Medicare Part B premiums by about $11 a month per beneficiary. CMS Administrator Dr. Mehmet Oz said in the DOJ announcement: “Prosecuting criminals who steal from American patients is necessary—but stopping them before a single dollar leaves the building is smarter.”

The department said this year’s takedown also relied in part on advanced data analytics, including work by its Health Care Fraud Unit’s Data Fusion Center, which DOJ has presented as a key tool for identifying billing patterns and coordinating cases across agencies.

The 2026 sweep involved more defendants than last year’s takedown, which DOJ said charged 324 defendants, but a lower aggregate alleged dollar figure than the 2025 total of $14.6 billion in intended loss. Those headline numbers should be read as government estimates tied to charged schemes, not court findings. In health care fraud cases, the alleged totals can include intended loss or false-claim calculations, and actual payments may be lower when claims are denied or stopped before money goes out.

Still, the breadth of the 2026 operation stood out. “This year’s National Health Care Fraud Takedown represents the greatest whole-of-government effort to combat health care fraud in our Nation’s history,” Acting Attorney General Todd Blanche said.