Nationwide $2.75 Billion Health Care Fraud Scheme Leads to 193 Charges

A sweeping nationwide health care fraud scheme has led to charges against 193 individuals, including 13 in New Jersey, for allegedly defrauding Medicare, Medicaid, TRICARE, and other private insurers of over $2.75 billion. U.S. Attorney Philip R. Sellinger announced the charges, which follow a two-week, coordinated law enforcement action. The investigation also resulted in the seizure of $231 million in cash, luxury vehicles, gold, and other assets.

In New Jersey, defendants were involved in a scheme to defraud the Amtrak health care plan, causing losses of approximately $11 million. These individuals, including Amtrak employees, allegedly allowed their insurance information to be used for false billing in exchange for kickbacks. Specific charges include conspiracy to commit health care fraud, with substantial financial losses attributed to their actions.

This coordinated effort highlights the commitment of federal agencies to combat health care fraud and hold accountable those who exploit health care systems for personal gain. The Department of Health and Human Services Inspector General and Attorney General Merrick B. Garland emphasized that fraudulent activities, regardless of the perpetrators’ status, will be vigorously prosecuted to protect patients and the integrity of health care programs.