According to court documents, Julian Lopez, a Cuban citizen who was residing in Miami-Dade County, sold off Medicare beneficiary information to a sham medical equipment company called One Medical Services, which then used those records to submit fraudulent reimbursement claims for orthotic braces never actually provided to patients.

In New Jersey, prosecutors say a women’s health center that was operating without a medical license fraudulently billed the state’s Medicaid program approximately 2,500 times from December 2020 to February 2024.

According to a recent press release from the New Jersey attorney general’s office, in addition to fraud-related crimes, two of the facility’s operators, both of whom were not licensed to practice medicine, were charged with performing illegal gynecological services on patients while unlicensed.

In New York, a Brooklyn banker with dual citizenship pleaded guilty last week to laundering more than $8 million in Medicare fraud proceeds on behalf of a transnational criminal organization.

Renat Abramov, a dual citizen of Azerbaijan and the United States, admitted to participating in a “sophisticated” international scheme as part of the organization’s network.

That organized crime syndicate alone has allegedly submitted over $10 billion in fraudulent Medicare claims across the country by stealing the identities of over 1 million Americans, including elderly and disabled citizens in all 50 states, according to the Justice Department.

Abramov, as a manager of an American bank branch, admittedly opened bank accounts for individuals, many of them not lawfully present in the U.S., who posed as owners of bogus medical supply businesses. Once the insurance checks from Medicare were deposited, members of the transnational criminal organization transferred the profits into offshore accounts and cryptocurrency.

Although the Somali-run scams have dominated the news cycle, Republicans in Congress are warning that what came to light in Minnesota is “merely the tip of the iceberg.”

House GOP leadership says such criminal schemes, for decades, have been diverting medically necessary resources from patients in need, using similar strategies, such as overbilling, forgery, identity theft, and phantom companies, to steal federal funds intended for elderly, impoverished, and terminally ill people.

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Nor is fraud the only driving force making these federally funded services less efficient and more financially burdensome on taxpayers. Waste has also been identified as a massive drainer of finite federal funding, with Obamacare reportedly playing a key role in exacerbating unnecessary spending and improper enrollments.

In July 2025, the Trump administration’s Centers for Medicare and Medicaid Services found that millions of people were likely enrolled in two or more Medicaid or Obamacare plans, meaning they were “double-dipping” in benefits.

An agency analysis of 2024 enrollment data identified 2.8 million people either enrolled in Medicaid or the Children’s Health Insurance Program in multiple states or simultaneously registered for both Medicaid or CHIP and a subsidized Affordable Care Act Exchange plan, also known as Obamacare.

Duplicate enrollments in the government health programs waste an average of $14 billion annually, according to CMS, due to the federal government having to pay twice for the same person’s medical care.

The Republican-led House Committee on Energy and Commerce has been working to ensure that ineligible recipients and fraudsters do not continue to drain taxpayer dollars through the Medicare and Medicaid programs.

“Fraud schemes and wasteful spending have plagued Medicaid and Medicare programs for years,” Rep. Brett Guthrie (R-KY), the committee chairman, told the Washington Examiner. “While waste, fraud, and abuse flourished, the Biden-Harris administration did nothing.”

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Guthrie noted that these scams cost taxpayers millions of dollars, fuel skyrocketing healthcare costs, and ultimately undermine the mission and purpose of such public assistance programs.

“Our committee is determined to root out waste, fraud, and abuse wherever we find it and ensure our most vulnerable Americans receive the high-quality, affordable care they are entitled to,” Guthrie said.

The committee’s latest efforts include an investigation it launched in January into Minnesota’s Medicaid fraud scandal and a letter that committee leadership sent to the Department of Health and Human Services inspector general’s office, requesting a meeting to discuss evidence of large-scale Medicare fraud in Los Angeles County.

Most recently, the Energy and Commerce Subcommittee on Oversight and Investigations held a hearing on Feb. 3 to examine the broader ecosystem of Medicare and Medicaid scams.

During the hearing, Rep. Russ Fulcher (R-ID) asked the expert witnesses if fraudsters target certain states with fewer safeguards in place against taxpayer theft.

“I’m from the state of Idaho, which, sometimes, may not be the first state you think about when there might be fraud, but that is kind of the basis of my question,” Fulcher said. “Have you noticed any trends where states might get targeted, or regions might get targeted as a function of potentially them having a lower barrier for entry, or maybe perceived as not being as likely to be audited?”

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Healthcare fraud investigator Jessica Gay, who helps clients identify patterns of fraud, told the committee, “Absolutely. We talk a lot in the industry about how [fraud] can be regionally generated.”

“It tends to start in one particular area,” she said, “and then I don’t know if they’re all hanging out, talking to each other, or how that spreads, but it does tend to start in certain populations and then branch out from there based on controls.”