Large-scale transnational medical insurance fraud: 320 people embezzled 14.6 billion yuan, nearly 100 practicing medical personnel were prosecuted
On the 30th, the Federal Department of Justice announced that it had cracked a transnational health insurance fraud case involving up to 14.6 billion yuan in false claims and fraud, and had charged more than 320 people, some of whom were criminals from Russia, Eastern Europe, Pakistan and other countries.
This is the largest scale of health insurance fraud that the Department of Justice has ever cooperated with the states to fight. Law enforcement agencies have seized more than 245 million yuan in cash, luxury cars, cryptocurrencies and other assets. Involving nearly 190 federal cases and more than 90 state-level cases, in addition to foreign criminals, nearly 100 practicing medical personnel in the United States have been prosecuted, including 25 doctors. The actual loss reported by the government is 2.9 billion yuan.
Among them, in the case code-named “Operation Gold Rush”, 19 people were charged, involving multiple foreigners, mainly from Eastern Europe, of whom 4 were arrested in Estonia and 7 were arrested at US airports and the US-Mexico border. The Department of Justice pointed out that the criminal group stole the identities and personal information of more than 1 million Americans.
Operation Gold Rush involved catheter fraud worth up to $10 billion. The criminal organization behind it used foreign “shell companies” to secretly acquire dozens of medical supply companies in the United States, stealing the identities and confidential health data of a large number of catheter patients through these companies, and then submitting false federal Medicare (commonly known as the red and blue card) claims.
Mehmet Oz, director of the Centers for Medicare and Medicaid Services (CMS), said that this was not the work of ordinary small-scale criminals, but an organized international criminal group that intended to harm the United States.
Matthew Galeotti, head of the Criminal Division of the Department of Justice, said at a press conference on the 30th that these criminals did not just steal other people’s money, they stole the things of the American people. Every fraudulent claim, every false bill, and every kickback plan meant stealing money directly from the pockets of American taxpayers.
Prosecutors warned that transnational criminal networks tried to use the US healthcare system to defraud; law enforcement authorities also pointed out that this highlighted the increasingly sophisticated fraud methods of transnational criminal organizations.
