Daily Briefing

Around the nation: DOJ unveils largest-ever healthcare fraud case


The Department of Justice (DOJ) last month announced that it had criminally charged 324 people involved in $14.6 billion in healthcare fraud, making it the agency's largest fraud operation to date, in today's bite-sized hospital and health industry news from the District of Columbia, Maryland, and New Jersey. 

  • District of Columbia: Late last month, DOJ announced that it had criminally charged 324 people, including almost 100 healthcare professionals, involved in $14.6 billion in healthcare fraud. The operation, which was called the 2025 National Health Care Fraud Takedown, is the largest in DOJ history — more than double its previous record of $6 billion. DOJ's criminal division, HHS' Office of Inspector General, the FBI, and the Drug Enforcement Administration all worked together on the investigation. The largest case of the investigation was Operation Gold Rush, which involved $10.6 billion in fraudulent Medicare claims using stolen identities and medical data from over 1 million Americans. Overall, federal officials seized over $245 million in cash, luxury vehicles, cryptocurrency, and other assets during their investigation. The total loss to the government was around $2.9 billion. Last week, DOJ unveiled a new "healthcare data fusion center," which will use technology to detect, investigate, and prosecute healthcare fraud. Separately, CMS Administrator Mehmet Oz said the agency plans to create a similar "war room" to prevent cyberattacks that could lead to healthcare fraud. (Vogel, Healthcare Dive, 7/1; Cass, Becker's Hospital Review, 6/30)
  • Maryland: FDA has restricted the import of several medical devices manufactured by Olympus Medical Systems and its subsidiaries in Japan due to ongoing violations of federal quality system regulations. According to FDA, it is concerned about deficiencies at Olympus' Aizu manufacturing facility despite efforts to address compliance issues. In response, the agency issued Import Alert 89-04, which prevents Olympus devices, including ureterorenoscopes, bronchoscopes, laparoscopes, and automated endoscope reprocessors, from entering the United States. Although new products cannot be imported, healthcare providers can continue using affected devices already in circulation if they have not experienced any issues, FDA said. (Murphy, Becker's Hospital Review, 6/26)
  • New Jersey: Novo Nordisk has signed a partnership with WeightWatchers to increase access to its weight-loss drug Wegovy, expanding its collaborations with telehealth companies. Through the partnership, WeightWatchers customers will be able to access Wegovy through Humana's CenterWell Pharmacy, which will fulfill and deliver the medications. "WeightWatchers has spent over six decades building a science-backed approach to weight management and we see strong synergy in our shared commitment to improving long-term health outcomes," said Dave Moore, EVP of Novo's U.S. operations. "We will continue to pursue and build on agreements with companies that share our values and refine initiatives that help improve access to our FDA-approved medicines for patients." He also noted that company has been "encouraged by its existing collaborations with telehealth companies Ro and LifeMD." However, Novo recently ended its partnership with another telehealth company, Hims & Hers, due to concerns about it selling and promoting compounded GLP-1 drugs. In response, Hims & Hers said Novo was "misleading the public" and that it wanted to provide patients with a range of options for weight-loss medications. (Landi, Fierce Healthcare, 6/26)

C-Suite Cheat Sheet: Fraud and Abuse

Download our cheat sheet to learn about fraud and abuse regulations, how to guard against potential violations, and prepare to have conversations with health system executives about compliance programs.


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