NATIONAL HEALTH CARE FRAUD TAKEDOWN RESULTS IN 455 DEFENDANTS CHARGED IN CONNECTION WITH OVER $6.5 BILLION IN ALLEGED FRAUD

The following information was released by the U.S. Department of Justice:

Today, United States Attorney Jason A. Reding Quiones for the Southern District of Florida announced criminal charges against 12 defendants in connection with alleged schemes to defraud Medicare, Medicaid, the Federal Employees Health Benefit Program (FEHBP), and private insurers. The charges filed in federal court are part of the Department of Justice's 2026 National Health Care Fraud Takedown. The charges stem from schemes involving over $4 billion dollars in fraudulent claims for DME, skin substitutes and wound care products, laboratory testing, and community mental health services that were medically unnecessary, procured by kickbacks to marketers and beneficiaries, and not provided, some of which involved transnational criminal organization activity and significant patient harm and risk to public safety.

"Health care fraud isn't just fraud, it's stealing from every American taxpayer. This Department of Justice is no longer satisfied with chasing stolen money after it's gone," said U.S. Attorney Reding Quiones. "We're using data to detect suspicious claims earlier, prevent fraudulent payments whenever possible, seize the proceeds of fraud, and bring those responsible before the courts. If you choose to exploit our health care system for personal gain, expect to lose your money, your assets, and your freedom."

"Health care fraud is more than a financial crime. Every dollar stolen through fraud is a dollar diverted from patient care, medical services, and programs that millions of Americans depend upon. The impact is felt not only in government-funded health care programs, but throughout the entire health care system," said Special Agent in Charge Brett Skiles of FBI Miami. "The FBI and our partners work tirelessly to investigate health care fraud, but we cannot do it alone. If you believe you have information related to healthcare fraud or someone you know may have been a victim, file a complaint at the FBI's Internet Crime Complaint Center atic3.gov."

"In the far-reaching enforcement action announced today, the HHS Inspector General's Office and our law enforcement partners effectively shut down an expansive array of alleged high-dollar, corrosive health care fraud schemes and are bringing those we believe responsible to justice," said Special Agent in Charge Isaac M. Bledsoe of the Department of Health and Human Services Office of Inspector General (HHS-OIG). "Simply put, fraudsters who exploit Medicare and Medicaid patients and jeopardize these safety net health care programs to enrich themselves will be held accountable for their crimes."

"Medicaid is your tax dollars meant to help sick children, disabled adults, and struggling families get the doctor visits, therapy, and daily care they need. When someone cheats the system, they steal from the very people who need it most," said Florida Attorney General James Uthmeier. "My office will keep working with our state and federal law enforcement partners to protect your taxpayer dollars so they work for the people who need itnot the cheaters."

The charges announced today by U.S. Attorney Reding Quiones are part of a strategically coordinated, nationwide law enforcement action that resulted in charges against 455 defendants, including 90 doctors and other licensed medical professionals, for their alleged participation in health care fraud and opioid abuse schemes involving over $6.5 billion in false claims and significant patient harm, including death. This Takedown represents a new era in federal, state, and international cooperation to combat health care fraud: cases in 56 federal districts and 45 U.S. states and territories, with 50 state Medicaid Fraud Control Units participating, the most in Department history. In addition, unprecedented international cooperation over the two-week Takedown resulted in the apprehension and return to the United States of the following health care fraudsters: one defendant in Kyrenia in connection with an over $3.7 billion scheme; two defendants in Estonia in connection with a previously charged $10.6 billion scheme; and, in the Philippines, one of FBI's Most Wanted Fraudsters in connection with a previously-charged $1.2 billion telemedicine fraud scheme. The Takedown involves the cutting-edge use of data analytics to target the worst actors; the seizure of over $182 million in cash, luxury vehicles, jewelry, and other assets; and full-spectrum accountability for all criminal actors from doctor's offices to corporate boardrooms.

This coordinated enforcement action involves a whole-of-government approach, including:

Actions by the Centers for Medicare and Medicaid Services (CMS) to suspend 1,079 providers and revoke billing privileges for 1,403 providers.

48 Civil Monetary Payment settlements amounting to over $73 million, over 1,400 provider exclusions, and 25 actions by the HHS-OIG under the Civil Monetary Penalties Law seeking more than $10 billion in payments to the Medicare Trust Fund from payments that CMS caught and suspended before the funds were paid to the fraudulent providers.

Civil charges against 13 defendants for $14.8 million in health care fraud schemes, as well as civil settlements with 31 defendants totaling $23 million.

928 administrative cases by the Drug Enforcement Administration (DEA) seeking the revocation of authority to handle and/or prescribe controlled substances since October 1, 2025.

The following individuals were charged in the Southern District of Florida in connection with the following types of health care fraud schemes:

Fraudulent Wound Care Schemes

Casilda Muniz Rodriguez, 57, of Hialeah, was charged by information with conspiracy to defraud the government in connection with her role setting up clinics in South Florida that fraudulently billed Medicare for over $117 million for skin substitutes and wound care products that were never provided. Muniz Rodriguez worked with the clinics' true owners to set up the clinics and fraudulently listed only the names of nominee owners on the paperwork enrolling the clinics with Medicare. Muniz Rodriguez set up at least 11 of these fraudulent clinics, and Medicare paid over $55 million based on the clinics' fraudulent claims. The case is being prosecuted by Acting Assistant Chief Jil Simon and Trial Attorney Emmanuel Hampton of the Florida Strike Force and Assistant U.S. Attorneys Sally Molloy and Jacqueline DerOvanesian for the Southern District of Florida.

In this Takedown, the Department announced the seizure of over $27 million in fraudulent Medicare payments in the Southern District of Florida as part of a data-driven effort to target "bust-out schemes" involving 12 clinics that billed Medicare millions of dollars for skin substitutes and wound care products that were never provided to patients. This novel and proactive "follow and seize the money" approach maximized recovery of stolen taxpayer dollars.

Schemes Posing Significant Patient Harm and Risk to Public Safety

Dr. Jason Finkelstein, 53, of Fort Worth, Texas, was charged by indictment with conspiracy to commit health care fraud and wire fraud, and health care fraud, in connection with an $89 million cardiovascular testing scheme. As alleged in the indictment, Finkelstein, a board-certified cardiologist licensed in 48 states, was the medical director of a cardiovascular testing company, Company 1, that conducted cardiovascular tests on student athletes at school campuses across the United States. Finkelstein conspired with others to use two companies that he owned, Cardiovascular Testing Services PA and Cardiovascular Healthcare Associates PA, to submit approximately $89 million in false and fraudulent claims to private and public insurers for cardiovascular tests conducted by Company 1, of which approximately $13.1 million was paid. As alleged in the indictment, Finkelstein was the only referring/ordering provider for Company 1's claims, but he did not conduct any clinical examination to determine whether the student athletes had a clinical diagnosis that warranted the cardiovascular tests. Despite this, the claims fraudulently included false diagnoses for student athletes to induce the insurance companies to pay for the tests. The claims also falsely stated that Finkelstein was the reviewing provider for the tests, when, in fact, he signed and approved the cardiovascular test results within a few seconds of accessing the tests. In October 2024, Finkelstein signed the cardiovascular tests of one student athlete as "normal" even though some of the tests included unconfirmed interpretations noting potential cardiovascular abnormalities. Approximately 24 days later, the student died from sudden cardiac arrest while exercising with his basketball team. Even though Finkelstein was informed of the student's death, Finkelstein did not change his practice of signing and approving the cardiovascular test results without meaningfully reviewing them, and Cardiovascular Testing Services PA and Cardiovascular Healthcare Associates PA continued to bill insurers for those tests. In connection with today's announcement, HHS-OIG separately issued aconsumer alert to inform student athletes, family members, and the public about cardiovascular testing scams. The case is being prosecuted by Trial Attorney Aisha Schafer Hylton of the Florida Strike Force.

Eduardo Javier Ibarra Arrowsmith, 61, of Miami, was charged by criminal complaint with fraud and misuse of visas, permits, and other documents and aggravated identity theft in connection with a scheme to fraudulently certify naturalization applicants as disabled in order to exempt them from the English language and civics requirements of the U.S. citizenship naturalization test. As alleged in the complaint, Ibarra, a Cuban national and convicted felon posing as a licensed medical doctor, impersonated a deceased Miami-Dade neurologist and used that doctor's credentials including his name, National Provider Identifier number, and Florida medical license number to fraudulently complete and sign at least 34 USCIS Form N-648 Medical Certification for Disability Exceptions, resulting in 14 naturalization applicants obtaining U.S. citizenship without completing the required testing. The case is being prosecuted by Assistant U.S. Attorney Noah P. Dorman for the Southern District of Florida.

Transnational Organizations and International Cooperation

Ibrahim Hilmi, 58, of Miami, was charged by indictment with health care fraud and wire fraud conspiracy, money laundering conspiracy, and money laundering, in connection with a $3.76 billion health care fraud scheme. As alleged in the indictment, Hilmi was involved in the operation of ABRH Care, Inc., and Sunshine Senior Solutions LLC, two entirely fraudulent durable medical equipment companies that submitted claims to Medicare, Medicaid, and other insurers for billions of dollars of medical equipment and wound dressings that the companies never provided. Hilmi used his control of Sunshine Senior Solutions' corporate bank accounts to deposit the proceeds of these fraudulent claims into those accounts, and to wire millions of dollars of fraud proceeds out of the United States to a foreign entity located in Hong Kong. In total, ABRH and Sunshine Senior Solutions submitted at least $3.76 billion in fraudulent claims to Medicare, Medicaid, and other insurers, but only approximately $5.7 million was deposited into ABRH and Sunshine Senior Solutions bank accounts. The case is being prosecuted by Trial Attorney Claire Horrell of the Florida Strike Force.

Giorgi Kimeridze, 43, a national of the country of Georgia, was charged by complaint with conspiracy to commit money laundering in connection with his role in a multi-billion-dollar health care fraud and money laundering scheme to target, exploit, and steal from Medicare, which was uncovered through Operation Gold Rush. As alleged in the complaint, Kimeridze participated in the laundering of fraud proceeds obtained from at least two durable medical equipment (DME) companies that were part of the health care fraud scheme. Together the DME companies billed Medicare, Medicare Supplemental Insurers, Medicare Advantage Organizations, and the Federal Employees Health Benefits Program (FEHBP) more than $1 billion, of which approximately $4.9 million was paid. The case is being prosecuted by Trial Attorneys Claire Horrell of the Florida Strike Force and Leonid Sandlar of the Northeast Strike Force.

DME and Laboratory Testing Schemes

Laura Seiler-Anstett, 55, of Coral Springs, was charged by indictment with conspiracy to commit health care fraud and wire fraud, and health care fraud, in connection with a $58.3 million DME scheme. As alleged in the indictment, Seiler-Anstett, a biller and consultant, submitted and conspired with others to submit approximately $58.3 million in false and fraudulent claims to Medicare, of which approximately $30 million was paid. The fraudulent claims were for orthotic braces that were medically unnecessary, ineligible for reimbursement, and procured through the payment of illegal kickbacks and bribes. The fraudulent claims were submitted to Medicare on behalf of fourteen DME supply companies. The case is being prosecuted by Trial Attorney Aisha Schafer Hylton of the Florida Strike Force.

Rajiv Shah, 65, of Palm Beach Gardens, was charged by indictment with conspiracy to commit health care fraud and wire fraud, and health care fraud, in connection with an over $64 million scheme to submit fraudulent claims to Medicare for medically unnecessary DME. As alleged in the indictment, Shah, as the owner and operator of ACC-Q Data, LLC, a medical billing company, conspired with owners and operators of DME companies to submit fraudulent claims to Medicare. Medicare paid over $23 million based on those claims. Shah advised the DME companies how to avoid scrutiny from Medicare for the medically unnecessary DME and how to conceal the fraudulent nature of these claims. The case is being prosecuted by Trial Attorney Jody King of the Florida Strike Force.

Anthony Tursi, 39, of Boynton Beach, was charged by information with conspiracy to commit health care fraud and conspiracy to pay and receive health care kickbacks in connection with a $62 million scheme to bill Medicare for medically unnecessary genetic testing. As alleged in the information, Tursi owned a call center through which he sold doctors' orders for genetic tests to laboratories by running deceptive telemarketing campaigns to persuade the Medicare beneficiaries to agree to the tests. His call center then would "doctor chase" the beneficiaries' physicians to sign orders for the tests by sending them faxes containing false, fraudulent, and misleading representations designed to induce them into ordering the tests. The case is being prosecuted by Trial Attorney Reginald Cuyler Jr. of the Florida Strike Force.

Medicaid Fraud

Yilian Cruz, 36, of Miami Lakes,Inti Cruz, 55, of Miami Lakes, andAdaimis Perez Arencibia, 39, of Miami, were charged by information with conspiracy to commit health care fraud in connection with a scheme involving over $1 million in fraudulently obtained Medicaid reimbursements for PSR services. As alleged in the informations, the Cruzes were the married co-owners of De La Cruz Mental Health LLC (De La Cruz), a Miami mental health clinic where Perez Arencibia worked as a therapist. The Cruzes worked with other co-conspirators to pay illegal kickbacks to elderly Medicaid beneficiaries in order to recruit them as patients and trained therapists, including Perez Arencibia, to implement a false and fraudulent policy that permitted elderly patients to attend only two of their scheduled four PSR days per week while falsely signing attendance sheets reflecting attendance on all four days despite knowing that patients attended only two days. The case is being prosecuted by Assistant U.S. Attorney Noah P. Dorman for the Southern District of Florida.

Rene Yartu Couceiro, 57, of Miami, was charged by information with conspiracy to make false statements relating to health care matters in connection with a Medicaid and Medicare fraud scheme involving a Miami mental health clinic's payment of "donations" in the form of cash payments to Medicaid and Medicare beneficiaries for agreeing to receive psychosocial rehabilitation (PSR) and Transcranial Magnetic Stimulation (TMS) therapy that was not all provided as represented. As alleged in the information, Couceiro was a therapist who conducted group mental health therapy sessions for patients who were expected to attend therapy sessions approximately four days per week. More than half of his patients allegedly were permitted to attend only some of their scheduled therapy sessions while still signing attendance records for all four scheduled therapy days. During an audio/video-recorded meeting with a cooperating patient, Couceiro had the patient sign an attendance record for TMS therapy when the patient had not received therapy on that day. The case is being prosecuted by Assistant U.S. Attorney Noah P. Dorman for the Southern District of Florida.

As discussed above, $27,425,929 of health care fraud proceeds were seized pursuant to seizure warrants and civil forfeiture complaints from bank accounts belonging to 12 different clinics in South Florida: Always Medical Center Corp., Caso Quality East Corp., CRC Management, Envy South Florida Medical Center, H Services Corp., Hamilton State Inc., Medmed 137 Inc., Miami Special Care, Nakelly Medical Center Corp., Pronto Medical Center, Theron Medical Center LLC, and VCG Best Services. The seizure warrants and civil forfeiture complaints allege that the clinics were "bust outs" billing Medicare for amniotic wound allografts and services that were never provided. The seizure initiative is being led by Acting Assistant Chiefs Jil Simon and Keith Clouser, and Trial Attorney Owen Dunn, of the Florida Strike Force, Assistant Chief Jamie de Boer of the National Rapid Response Strike Force, and Assistant U.S. Attorneys Sally Molloy, Elizabeth Young, Gabrielle Charest-Turken, Nadya Cheatham, Sandra Demirci, Daren Grove, Mitch Hyman, and Brian Zack of the Southern District of Florida.

The cases are being prosecuted by the Health Care Fraud Unit's National Rapid Response, Florida, Gulf Coast, Los Angeles, Midwest, New England, Northeast, Texas, and West Coast Strike Forces; U.S. Attorneys' Offices for the Middle District of Alabama, District of Arizona, Central District of California, Southern District of California, District of Colorado, District of Connecticut, District of Delaware, Middle District of Florida, Northern District of Florida, Southern District of Florida, Northern District of Georgia, District of Hawaii, District of Idaho, Northern District of Illinois, Northern District of Iowa, Southern District of Iowa, Western District of Kentucky, Eastern District of Louisiana, Middle District of Louisiana, District of Massachusetts, Eastern District of Michigan, Southern District of Mississippi, District of Montana, District of Nebraska, District of New Hampshire, District of New Jersey, District of New Mexico, Eastern District of New York, Northern District of New York, Southern District of New York, Eastern District of North Carolina, Middle District of North Carolina, Western District of North Carolina, Northern District of Ohio, Northern District of Oklahoma, Western District of Oklahoma, District of Oregon, Eastern District of Pennsylvania, Middle District of Pennsylvania, Western District of Pennsylvania, District of Puerto Rico, District of Rhode Island, District of South Carolina, District of South Dakota, Middle District of Tennessee, Western District of Tennessee, Northern District of Texas, Southern District of Texas, Western District of Texas, District of Vermont, Eastern District of Virginia, Western District of Virginia, Northern District of West Virginia, Southern District of West Virginia, Eastern District of Wisconsin, and Western District of Wisconsin; and State Attorneys General's Offices, through their MFCUs, in Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, Ohio, Oklahoma, Oregon, Pennsylvania, Puerto Rico, Rhode Island, South Carolina, Tennessee, Utah, Vermont, Virgin Islands, Washington, Wisconsin, and West Virginia. In addition, the MFCUs for Alabama, North Carolina, South Dakota, Texas, and Virginia participated in the investigation of the federal cases announced.

Descriptions of each case involved in the enforcement action are available on the Department's websitehere.

The civil forfeiture complaints for the Southern District of Florida are availablehere.

Prosecutors in the Southern District of Florida's Health Care Fraud Unit of the Economic Crimes and Cyber Frauds Section and the Department's Health Care Fraud Unit of the Fraud Division comprise the Florida Strike Force and worked with the following law enforcement agencies to investigate and prosecute the cases filed during the Takedown: the HHS-OIG; FBI; Department of Homeland Security, Homeland Security Investigations (HSI) and U.S. Citizenship and Immigration Services (USCIS); the Florida Medicaid Fraud Control Unit; Department of Labor Office of Inspector General; IRS; and DEA.

On April 7, the Department of Justice announced the creation of the National Fraud Enforcement Division (Fraud Division). The Fraud Division is laser-focused on investigating and prosecuting those who commit fraud against the American people. The Department's work to combat fraud supports President Trump's Task Force to Eliminate Fraud, a whole-of-government effort chaired by Vice President J.D. Vance to eliminate fraud, waste, and abuse within Federal benefit programs.

An indictment, information, or complaint is merely an allegation. All defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.

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