On June 30, the U.S. Department of Justice (DOJ) announced the results of its 2025 National Health Care Fraud Takedown, a coordinated takedown of health care fraud schemes across the country which involved over $14.6 billion in intended loss.
According to the DOJ, the takedown is the largest in department history and “resulted in criminal charges against 324 defendants, including 96 doctors, nurse practitioners, pharmacists, and other licensed medical professionals, in 50 federal districts and 12 State Attorneys General’s Offices across the United States.”
“This record-setting Health Care Fraud Takedown delivers justice to criminal actors who prey upon our most vulnerable citizens and steal from hardworking American taxpayers,” said Attorney General Pamela Bondi. “Make no mistake – this administration will not tolerate criminals who line their pockets with taxpayer dollars while endangering the health and safety of our communities.”
Among the cases which made up the takedown were some stemming from qui tam whistleblower lawsuits filed under the False Claims Act. The False Claims Act’s qui tam provisions enable private citizens and private parties to file lawsuits on behalf of the government if they know of an individual or company defrauding the government. Qui tam whistleblowers are eligible to receive between 15 and 30% of the government’s recovery.
In one case, two individuals and the pharmacies they operated, Kirtland Corp. a/k/a New Millennium Drugs and Western Wayne Pharmacy, LLC, agreed to pay $1,500,000 to resolve a civil qui tam lawsuit “alleging that they violated the False Claims Act by submitting false claims to the Medicare and Medicaid Programs for prescription drugs that New Millenium Drugs and Western Wayne Pharmacy billed to the Programs, but never dispensed.”
In another case, Villa Financial Services LLC, Villa Olympia Investment LLC, and six southeast Michigan Villa nursing homes agreed to pay $4,500,000 to “resolve a civil qui tam lawsuit alleging that they violated the False Claims Act by systematically failing to provide services to nursing home residents and/or providing materially and grossly substandard services to nursing home residents.”
“The Criminal Division is intensely committed to rooting out health care fraud schemes and prosecuting the criminals who perpetrate them because these schemes: (1) often result in physical patient harm through medically unnecessary treatments or failure to provide the correct treatments; (2) contribute to our nationwide opioid epidemic and exacerbate controlled substance addiction; and (3) do all of that while stealing money hardworking Americans contribute to pay for the care of their elders and other vulnerable citizens,” said Matthew R. Galeotti, Head of the Justice Department’s Criminal Division. “The Division’s Health Care Fraud Unit and U.S. Attorneys’ Offices stand united with our law enforcement partners in this fight, and we will continue to use every tool at our disposal to protect the integrity of our health care programs for the American people.”
During FY 2024, settlements and judgments under the False Claims Act exceeded $2.9 billion and over $2.4 billion of the recoveries stemmed from qui tam whistleblower lawsuits. Furthermore, according to the government, a record 979 qui tam lawsuits were filed in FY 2024.
However, in September 2024, a district judge in Florida ruled that the False Claims Act’s qui tam provisions were unconstitutional. The U.S. federal government is urging the U.S. Court of Appeals for the Eleventh Circuit to reverse that decision, stating in a brief that “other than the district court here, every court to have addressed the constitutionality of the False Claims Act’s qui tam provisions has upheld them.”
National Whistleblower Center has issued an Action Alert allowing whistleblower supporters to write the members of Congress urging them to protect and strengthen and protect the False Claims Act.
The claims asserted in this case are allegations only, and there has been no determination of liability.
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