U.S. Healthcare Fraud Takedown 2025
A White Paper Synthesizing one of the Largest Enforcement Actions in American History
November 5, 2025
By Jolee Patnaude, CPC, CPCO, CPB, MBA, Whitley Penn Revenue Cycle Management Director
November 5, 2025
By Jolee Patnaude, CPC, CPCO, CPB, MBA, Whitley Penn Revenue Cycle Management Director
In June 2025, the U.S. Department of Justice (DOJ), in coordination with the Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Drug Enforcement Administration (DEA), and 50 U.S. Attorneys’ Offices, executed the largest healthcare fraud enforcement operation in American history. The takedown resulted in 324 defendants charged across 50 federal districts and 12 State Attorneys General Offices, uncovering more than $14.6 billion in fraudulent claims. This white paper outlines the scope of the investigation, mechanisms of fraud, enforcement outcomes, and policy recommendations aimed at strengthening compliance, oversight, and fraud prevention.
The time frame of the investigated fraudulent schemes spanned from 2018 to 2025, with peak activity between 2021 and 2024, coinciding with the COVID-19 pandemic and emergency billing waivers. The individuals involved in these schemes were 96 licensed medical professionals, including physicians, nurse practitioners, and pharmacists. These individuals were all charged, underscoring the infiltration of fraud into legitimate healthcare practices – and marking a historic milestone in U.S. enforcement.
Fill out the short form below to unlock critical findings, policy implications, and our recommendations.
The time frame of the investigated fraudulent schemes spanned from 2018 to 2025, with peak activity between 2021 and 2024, coinciding with the COVID-19 pandemic and emergency billing waivers. The individuals involved in these schemes were 96 licensed medical professionals, including physicians, nurse practitioners, and pharmacists. These individuals were all charged, underscoring the infiltration of fraud into legitimate healthcare practices – and marking a historic milestone in U.S. enforcement.
Fill out the short form below to unlock critical findings, policy implications, and our recommendations.
