DOJ’s Second National Health Care Fraud Takedown of the Second Trump Administration Heavily Targets Medicaid Fraud

On June 23, 2026, the U.S. Department of Justice (“DOJ”) announced the results of the annual National Health Care Fraud Takedown (“2026 Takedown”)—the first under DOJ’s new National Fraud Enforcement Division (“NFED”) announced on April 7.

This year, the 2026 Takedown charged 455 defendants in connection with more than $6.5 billion in alleged fraud.

Although much of the content of the prosecutions is the same as in past years (e.g. wound care, opioids), Medicaid fraud—long the province of state Medicaid Fraud Control Units (“MFCUs”)—featured prominently in the 2026 Takedown. DOJ claims to have charged the largest number of Medicaid fraud defendants and Medicaid fraud loss in DOJ history: 295 defendants and over $518 million in alleged false claims submitted to Medicaid. Per the DOJ press release, the MFCUs of all 50 states participated, the highest number ever.

What Is New?

Medicaid Fraud

DOJ’s new focus on Medicaid fraud is significant. Although the agency has traditionally partnered with MFCUs for many years (see related EBG blog post), the federal government is now applying various forms of pressure on the states’ MFCUs to investigate and prosecute Medicaid provider fraud.

Recent federal actions demonstrating this trend include:

• April 23, 2026: The Centers for Medicare and Medicaid Services (“CMS”) asked state governors and directors of Medicaid programs (for example, the governor of Alabama) to “undertake a swift revalidation of Medicaid providers of services at high risk of waste, fraud, abuse, and corruption” and to provide a two-year revalidation strategy to CMS within 30 days.
• May 13, 2026: CMS announced a review of every state’s MFCU on the same day that the U.S. Department of Health and Human Services Inspector General sent a letter to all state Attorneys General threating to withhold funding for MFCUs that were not performing to DOJ standards. These letters were more warning than collaboration: “You are in charge of making sure that your MFCU meets [regulatory] requirements. And as Inspector General of HHS, my job is to make sure that you are living up to your obligations and using money dedicated to MFCUs to fight fraud.”
• May 21, 2026: In connection with announcing a Minnesota-only health care fraud takedown, DOJ announced that the NFED would hire 15 new Trial Attorneys as part of the Strike Force to combat Medicaid fraud. DOJ called out California, Florida, New York, and Texas as states that will receive these extra prosecutors.
• June 4, 2026: HHS denied recertification for the Hawaii MFCU for lack of prosecutions or indictments from 2022-2025, calling that MFCU “ineffective in fighting Medicaid fraud.”  

Use of DOJ Strike Forces

As we wrote in May, the newly constituted DOJ NFED announced the formation of a West Coast Health Care Fraud Strike Force on April 30, 2026. An expanded Midwest Strike Force was announced on May 22. In announcing the 2026 Takedown, DOJ noted the participation of at least eight of these regional strike forces, as well as U.S. Attorney’s Offices and state attorney general’s offices, through their MFCUs, in addressing Medicaid fraud.

What Has Stayed the Same

Targeting Overseas Actors

DOJ continues to pursue alleged international schemes, including one defendant in Cyprus connected to conduct implicating more than $3.7 billion; two defendants in Estonia in connection with a previously charged $10.6 billion scheme; and, in the Philippines, one of the FBI’s Most Wanted Fraudsters in connection with a previously charged $1.2 billion telemedicine fraud scheme.

Data Analytics

The 2026 Takedown boasts “the cutting edge use of data analytics to target the worst actors.” The Data Fusion Center announced as part of the 2025 Takedown “used advanced analytics in many of the cases charged[,]” along with the first prosecution arising from the Financial Intelligence Review Team. The Fraud Division also announced agreements with CMS, the Department of Homeland Security, and the Federal Trade Commission to further the effective use of data in identifying potential fraud.

Asset Seizures

Health care fraud enforcement efforts led to the seizure of $182 million in cash, luxury vehicles, jewelry, and other assets. This number is actually down from prior years, since the government seized $245 million in assets (including cryptocurrency) in 2025 and $231 million worth of cash, cars, and gold in 2024.

Civil Charges and Settlements

DOJ again included civil actions and settlements in its 2026 Takedown numbers. This includes 48 Civil Monetary Payment (“CMP”) settlements amounting to more than $73 million, more than 1,400 provider exclusions, and 25 actions by HHS-OIG under the Civil Monetary Penalties Law seeking more than $10 billion. Civil charges were also brought against 13 defendants for $14.8 million in health care fraud schemes, as well as civil settlements with 31 defendants totaling $23 million. As we predicted last year, emphasis on civil recoveries has now become the norm.

Provider Suspensions

In 2026, CMS took action to suspend 1,079 providers and revoke billing privileges for 1,403 providers. This far surpassed 2025 numbers, where CMS suspended or revoked the billing privileges of just 205 providers in the months leading up to the Takedown. The 455 defendants in the 2026 Takedown included 90 doctors and other licensed medical professionals—lower than the 2025 numbers—where 96 of the 324 defendants were doctors and other licensed medical professionals.

Other Types of Cases in this Year’s “Takedown”

Wound Care

Charges were filed against 11 defendants operating wound care businesses, including a company executive and eight medical professionals, across six districts in connection with billions of dollars in alleged fraudulent claims for amniotic wound allografts.

Patient Harm

DOJ described several cases involving schemes resulting in alleged patient harm, always a top prosecution priority.

Illegal Opioid Distribution

A total of 36 defendants, including 28 licensed medical professionals, were charged in connection with the alleged illegal diversion of prescription opioids and other controlled substances that resulted in patient harm. In 2025, 74 defendants, including 44 medical professionals, were charged in 58 cases. The 2026 Takedown included 928 administrative cases by the DEA seeking the revocation of authority to handle and/or prescribe controlled substances.

The DOJ press release provides additional graphics, case descriptions, and court documents on its website.

Takeaways

As always, these enforcement actions remind those involved in health care— whether as a provider, or elsewhere in the field—that appropriate compliance programs and general oversight remain critical. The 2026 Takedown again confirms, however, that DOJ is aggressively focused on investigating and prosecuting health care fraud and Medicaid fraud in particular—through traditional means as well as newly formed prosecuting structures, such as NFED.

We will continue to monitor these annual enforcement actions and other developments in this space.

To discuss how this impacts you or your company, please contact any of the authors.

Epstein Becker Green Staff Attorney Ann W. Parks contributed to the preparation of this post.