What were the largest healthcare fraud enforcement actions in 2024-2025 and which states were involved?
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Executive summary
The largest healthcare fraud enforcement actions across 2024–2025 were dominated by one massive, coordinated criminal initiative—the 2025 National Health Care Fraud Takedown—and by large civil False Claims Act (FCA) settlements and judgments that carried nine- and eight-figure price tags; the takedown charged 324 defendants for over $14.6 billion in intended losses and involved federal prosecutors in 50 districts and 12 State Attorneys General offices [1] [2]. Civil enforcement remained vigorous as well: 2024 federal FCA recoveries exceeded $1.6 billion in major settlements and a March 2025 $1.64 billion judgment entered after a late-2024 verdict underscored the continuation of high-value civil liability [3] [4].
1. The headline: 2025 National Health Care Fraud Takedown — scope and scale
In late June 2025, the Department of Justice and HHS-OIG announced the 2025 National Health Care Fraud Takedown that criminally charged 324 defendants in schemes with over $14.6 billion in intended loss, spanning pharmacy, telemedicine, substance diversion and billing fraud, and involved enforcement activity across 50 federal districts and coordination with 12 State Attorneys General’s offices [1] [2].
2. What the takedown recovered and who was targeted
The coordinated sweep resulted in the seizure of more than $245 million in cash, luxury vehicles, cryptocurrency and other assets and included charges against 96 licensed clinicians—doctors, nurse practitioners and pharmacists—reflecting DOJ’s targeting of medical professionals and affiliated pharmacies as alleged facilitators of large-scale fraud and diversion schemes [2] [5].
3. Big civil money: FCA settlements, judgments and the states’ rising role
Alongside criminal actions, civil enforcement remained consequential: DOJ and whistleblower-driven FCA suits produced more than $1.6 billion in settlements and judgments in 2024, and a notable late-2024 trial produced a $1.64 billion judgment entered in March 2025 that demonstrates continued high-stakes exposure for manufacturers and providers under civil theories such as off-label marketing and other FCA theories [3] [4].
4. State-level involvement and geographic hotspots
Federal announcements and reporting make clear states played an increasingly prominent role—12 State Attorneys General joined the 2025 takedown effort and state offices have at times led or amplified large matters—but publicly available summaries in these sources do not list all participating states by name, though targeted local investigations were highlighted (for example, Arizona Medicaid-related addiction treatment fraud drew Strike Force resources) [2] [6]. Where the sources name specific state-focused activity, Arizona was singled out as a hotspot for Medicaid fraud tied to addiction treatment services [6].
5. Trends, priorities and why the universe of “largest” actions matters
Enforcement officials and legal commentators describe 2024–2025 as a period of intensified, data-driven enforcement with priorities including Medicare Advantage, kickbacks, DME, telemedicine, laboratories and cybersecurity—areas that produced the headline takedown and large civil recoveries—and observers note a notable rise in state AG activity and in DOJ civil and criminal cross-coordination that increases the risk of parallel proceedings [4] [7] [8]. Analysts also point out that enforcement language from federal leaders and the expansion of initiatives like the Criminal Division’s whistleblower pilot may drive even more large, multi-jurisdictional actions going forward [9] [7].
6. Limits of the public record and the open questions
Available official summaries quantify defendants, alleged intended loss and asset seizures, and flag broad geographic reach, but they do not provide a complete roll call of every state involved in each large civil or criminal matter; therefore, while it is accurate to say 12 State Attorneys General participated in the 2025 takedown and Arizona was specifically cited in related enforcement work, the sources do not permit a definitive, source-cited listing of all states that were parties to every major enforcement action [2] [6].