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Medicare fraud cases

Federal prosecutions and settlements involving Medicare, compiled from Justice Department announcements, with a state-by-state breakdown.

DOJ announcements
397
Since January 20, 2025
Sentencings
108
Civil settlement 111 · Charged 72
Largest amount named
$1.2B
billed · 2025

Medicare fraud cases by state

Where to report Medicare fraud

Full steps and reward rules: how to report Medicare fraud.

Latest announcements

DateAnnouncementStateStageAmount
2026-10-20Illinois Laboratory Owner Charged in $66M COVID-19 Testing Fraud SchemeIllinoisCharged$66.2M
2026-10-16Two Florida defendants sentenced to prison for nearly $900,000 health care scamKansasSentenced$897K
2026-10-16Somerset Lifesciences Inc. Agrees to Pay $4M to Resolve Allegations of Causing Medicare to Pay Claims for its Mislabeled Generic DrugMulti-stateCivil settlement$4M
2026-10-16Connecticut Physician and His Practices Pay More Than $860K to Settle False Claims Act AllegationsConnecticutCivil settlement$867K
2026-10-15Staffing Business Owner and Son Indicted for Employment Tax and Wire Fraud SchemesMulti-stateCharged—
2026-10-15CVS Agrees to Pay $315M for Illegally Filling Unlawful Opioid Prescriptions and for Submitting False Claims to the Federal GovernmentHawaiiCivil settlement$315M
2026-10-14Medical Spa Business Owner Pleads Guilty to Employment Tax CrimesMulti-statePleaded guilty—
2026-10-13Former New Hampshire Doctor Sentenced to Year in Prison for Role in $1.9 Million Medicare Fraud SchemeNew HampshireSentenced$761K
2026-10-13Cape Cod Man Pleads Guilty to Conspiring to Launder Proceeds of $6M Medicare Fraud SchemeMulti-statePleaded guilty—
2026-10-09Medical Supply Company Owner Sentenced to 14 Years in Prison for $30M Medicare, TRICARE, and CHAMPVA FraudMulti-stateSentenced—
2026-10-09Maryland Man Facing Federal Indictment for Role in COVID-19 Healthcare Fraud Scheme Totaling More Than $100MMarylandCharged—
2026-10-08Massachusetts Doctor Sentenced to 36 Months in Prison for Participation in Multimillion-Dollar Medicare Fraud Scheme and for Violating the Federal Anti-Kickback StatuteNew JerseySentenced$27M
2026-10-08Lowell Man Sentenced for Felony Delay of MailIndianaSentenced—
2026-10-07Florida Laboratory Vice President and Marketer Convicted of Medicare Fraud for COVID-19 Testing SchemeFloridaConvicted at trial$15M
2026-10-06AIDS Healthcare Foundation Agrees to Pay $1.44M to Settle False Claims Act AllegationsCaliforniaCivil settlement$1.4M
2026-10-02Doctor Convicted for Conspiring to Distribute Over 2 Million Stimulant PillsMulti-stateConvicted at trial—
2026-09-29Gulf coast physician faces False Claims Act lawsuit in alleged Medicare fraudTexasOther$500K
2026-09-21Crown Medical Solutions and Its Owners to Pay $825,000 For Fraudulent Billing SchemeGeorgiaCivil settlement$825K
2026-09-15Repeat Felon Arrested and Charged in $4.75M Medicare Fraud SchemeMulti-stateCharged$4.8M
2026-09-11Eye Practice and Physician Owner Agree to Pay $350,000 to Resolve Allegations of False Claims to MedicareMassachusettsCivil settlement$350K
2026-09-10Dompé U.S. Agrees to Pay $32M to Resolve False Claims Act Liability Relating to Self-Disclosure of Patient KickbacksMassachusettsCivil settlement$32M
2026-09-10Brandon Pulmonary Practice Agrees to Pay Over $400,000 to Resolve False Claims Act ViolationsFloridaCivil settlement$419K
2026-09-09Federal Court Orders Forfeiture of Approximately $7 Million and Three Vehicles Following Conviction of Jamie P. McNamaraLouisianaSentenced$55M
2026-09-08Foreign National Pleads Guilty To Health Care Fraud Scheme Targeting Medicare Advantage ProgramsCaliforniaPleaded guilty$137M
2026-08-31Champaign Business Owner Charged with Tax Fraud and Wire Fraud Related to COVID Relief FundsIllinoisCharged—

Source: U.S. Department of Justice press releases, classified by WHIP Reward. Each row is one press release; the same case can appear at several stages, so amounts should not be added. Charged cases are allegations. Search all 397 in the database.

Frequently asked questions

Where do I report Medicare fraud?

HHS Office of Inspector General (1-800-HHS-TIPS (1-800-447-8477)): Fraud in Medicare, Medicaid and other HHS programs. Medicare (1-800-MEDICARE (1-800-633-4227)): Questions about charges on your own Medicare statement. Senior Medicare Patrol: Free local help reviewing Medicare statements. America.gov/fraud (WHIP reward portal): Required route if you want a WHIP award of $10,000–$30,000.

Can I get a reward for reporting Medicare fraud?

Yes. HHS / Centers for Medicare & Medicaid Services programs are covered by the federal WHIP program, which pays $10,000–$30,000 per tip that leads to criminal charges. Larger cases can be brought under the False Claims Act, which pays 15–30% of what the government recovers.

Sources

  1. U.S. Department of Justice: Whistleblower Rewards Program
  2. Medicare.gov: Reporting Medicare fraud and abuse
  3. HHS-OIG: Report fraud
  4. U.S. Department of Justice press releases (justice.gov/news)