Between May 13 and June 1, 2026, the Department of Justice’s National Fraud Enforcement Division secured six separate jury trial convictions in five federal districts. The defendants span virtually every healthcare setting and role, from a software platform executive to a rural nurse practitioner. In total, alleged losses exceed $1.1 billion to Medicare, Medicaid, and other health benefit programs. The convictions in these cases illustrate and reconfirm the breadth and activeness of the DOJ’s current healthcare fraud enforcement activity.

Durable Medical Equipment and Telehealth Platform Fraud

The founder and CEO of an operating company for an online medical billing platform was convicted on charges related to health care fraud, wire fraud, and kickbacks.

The defendant was accused of using foreign call centers and spam mailers to pressure Medicare beneficiaries into accepting medically unnecessary orthotic braces and other durable medical equipment and arranging for telemedicine physicians to sign orders in exchange for payment. The government argued that, in many instances, signing doctors never spoke with the patients nor performed examinations necessary for such prescriptions. The total billings are alleged to have exceeded $1 billion, of which Medicare and other federal programs paid over $450 million. A co-defendant was previously convicted and sentenced to 15 years in federal prison.

Medicare Billing Fraud

A physician was found guilty by a jury of nine counts of wire fraud and three counts of obstruction of a criminal investigation.

This doctor was accused of billing Medicare millions of dollars for Botox injections that were never administered or were medically unnecessary, through her beauty and cosmetic services practice. The alleged scheme was identified by the DOJ Fraud Division’s Data Analytics Team, which flagged the doctor as a statistical extreme: Medicare had paid more claims for Botox from her than any other physician in the country. Her collections comprised roughly six times more than the next-highest group of providers. The physician was also alleged to have fabricated and altered patient records during the investigation.

In all, the defendant was found to have billed more than $19 million in medically unnecessary Botox injections, including for orders made when she was not in the office and even on vacation outside the country.

Narcotics Distribution and Kickbacks

In a case involving narcotics, a clinic owner was convicted of health care fraud, narcotics distribution, multiple kickback counts, and conspiracy charges.

The non-clinician owner of a substance abuse clinic was alleged to have operated it as a vehicle for drug diversion, kickbacks, and fraud against Medicare and Medicaid (for example, by billing for office visits at which he was the sole staff present and receiving kickbacks from a laboratory in exchange for patient referrals). Also at issue was prescribing activity for Suboxone, used to treat opioid use disorder. The government contended these prescriptions were ordered by a Florida nurse practitioner who oftendid not even speak to the patients. A drug ring allegedly operated openly on the clinic’s steps.

In a different case, an Advanced Registered Nurse Practitioner at a small rural pain clinic prescribed nearly one million opioid pills to almost 1,000 patients during the time period at issue, many of whom were addicted to drugs or were known to be diverting them for street sale. The defendant was alleged to have ignored obvious clinical signs of active drug abuse at the time of prescribing and continued issuing prescriptions even knowing patients were likely selling them. The government contended patients traveled hundreds of miles to the clinic specifically because the defendant was willing to prescribe.

Home Health

A jury found another defendant guilty of bribing a hospital discharge nurse with over $130,000 to identify Medicare patients and fax their confidential records without the patients’ knowledge or consent. The government presented evidence that these patient profiles were then used to bill Medicare for home health services using appropriated physician identities, when in fact no physician had ever evaluated the patients for that purpose.

Physical Therapy

A conviction was obtained against a defendant who managed a network of physical therapy clinics, whose patient referral pipeline ran through ambulette drivers rather than physicians. The government alleged cash kickback payments were paid to ambulette drivers, who then recruited Medicare patients for those clinics. The defendant then falsified medical records to indicate that licensed physical therapists had treated patients on days those therapists were not present at the clinic. Between 2018 and 2020, Medicare paid the clinics more than $8 million based on these records.

Key Takeaways

These convictions highlight several recurring compliance considerations for healthcare providers. Billing patterns that are statistical outliers relative to specialty peers have been a trigger for federal investigation. Violations of the Anti-Kickback Statute remain a significant focus. Referral and compensation arrangements, including laboratory agreements, transportation contracts, DME supplier relationships, and telemedicine partnerships, remain subject to ongoing scrutiny. Telehealth prescribing practices that lack well-documented patient interaction continue to draw enforcement attention, as do narcotics prescribing activities. Finally, the convictions reflect increasingly data-driven enforcement.

Written with the assistance of Kaylie Drysdale, a summer associate in Husch Blackwell’s Austin office.