The 2025 National Health Care Fraud Takedown exposed something federal prosecutors have long warned about: health care fraud is no longer just domestic. According to the DOJ’s announcement, 29 defendants were charged for their roles in transnational criminal organizations that submitted more than $12 billion in fraudulent claims to U.S. health insurance programs.

One case—Operation Gold Rush—accounts for $10.6 billion of that total. These aren’t isolated actors. These are organized operations built across borders, using straw owners, encrypted messaging, identity theft, and money laundering through crypto and shell companies. And if your name is even loosely connected to these networks, you’re already running out of time to act.

Waiting for an indictment or pretending you can distance yourself from the scheme is not going to work. These cases were built on data, wire transfers, and structured surveillance. If you’re caught up in one of these fraud webs, there is no “I didn’t know.” The only question is whether you’ll start building your defense and release plan before the government finalizes its case.

What Operation Gold Rush Reveals

The DOJ filed charges across five districts: Eastern District of New York, Northern District of Illinois, Central District of California, Middle District of Florida, and District of New Jersey. Twelve defendants were already arrested. Some tried to flee through U.S. airports or at the border with Mexico. Four were picked up in Estonia after international coordination with Estonian law enforcement.

According to the DOJ, these defendants:

• Used stolen identities of over 1 million Americans
  
• Bought dozens of medical supply companies
  
• Submitted billions in fraudulent Medicare claims for durable medical equipment
  
• Laundered proceeds through U.S. banks, cryptocurrency exchanges, and foreign shell entities
  

And even with enforcement catching much of it in time, $900 million in payments still went through. These aren’t small billing errors. This is organized theft at scale.

If you’ve worked for one of these companies, held a license tied to one, or processed claims under one of these providers, the government likely already has your name. What you do now—before your name appears in a charging document—can determine how your case is handled and how much room you have to negotiate.

The Window to Cooperate Is Narrow

This level of fraud doesn’t get handled with a simple civil settlement or a “wait and see” approach. Prosecutors and federal agents are looking for people who can help build the case from the inside. That window is small. The first to come forward gets the most benefit. If you’re the fifth or sixth in line, you’re likely just another name they’ve already decided to charge.

If you’re involved and know it, ask yourself: do you want to be one of the defendants caught in Estonia, or the person who worked early with their lawyer, came forward with documentation, and avoided indictment through a cooperation agreement?

What You Can Do Now

Start documenting your story. Work with experienced counsel. Don’t try to outsmart the government—they’re using data analytics, international law enforcement, and bank-level surveillance. You’re not going to beat that with silence or denials.

What you can do is prepare a full release plan and start publishing a record of your efforts. PrisonProfessorsTalent.com is built for that reason. Michael Santos pioneered this model by publishing his own release plan and encouraging others to follow. The DOJ may not mention it in their press releases, but prosecutors take those materials seriously—because they show planning, and concrete steps to repay losses, document progress, and show you’re no longer a risk.

Cooperation Must Be Backed by Action

You don’t cooperate by saying, “I’ll help.” You cooperate by proving you’re not trying to run. That means being honest, being early, and backing it up with a plan that shows you understand what happened—and that you’re working to repair it.

The defendants in Operation Gold Rush submitted billions in fraudulent claims. Most are now facing serious prison time. Some will spend years fighting extradition. If you’re involved in anything close to this kind of fraud and you haven’t prepared yet, you’re already behind.

Join our weekly webinar every Tuesday at 11AM Pacific / 2PM Eastern. Or schedule a personal call with us. The DOJ has already taken action. If your name is connected, you need a plan in place before they come to you.

Justin Paperny