Florida played a significant role in the Department of Justice’s 2026 National Health Care Fraud Takedown, the largest healthcare fraud enforcement action in U.S. history. Of the 455 defendants charged nationwide in schemes involving more than $6.5 billion in alleged fraud, 36 defendants were charged in Florida across the Southern, Middle, and Northern Districts. Federal prosecutors said South Florida cases alone involved more than $4 billion in alleged fraudulent claims.
For a state with one of the largest Medicare populations in the country, the scale of these cases is a reminder that oversight matters, and that patients and families have a right to understand the difference between a criminal fraud case and a civil medical negligence claim.
Why Florida Was a Major Focus of the Takedown
In the Southern District of Florida, federal prosecutors charged 12 defendants in connection with alleged schemes involving Medicare, Medicaid, the Federal Employees Health Benefits Program, and private insurers. The Middle District of Florida announced charges against nine additional individuals, while related cases were also brought in the Northern District of Florida. Together, Florida cases accounted for 36 defendants charged as part of the nationwide operation. Prosecutors allege that the South Florida cases alone involved more than $4 billion in fraudulent claims.
Notable Florida Cases in the 2026 Takedown
According to the Department of Justice and federal court filings, Florida cases in this year’s takedown included allegations such as:
- A Miami man accused of directing a scheme in which fraudulent claims for medical supplies allegedly totaled billions of dollars, with the individual apprehended overseas and returned to the United States as part of international law enforcement cooperation.
- A Hialeah woman accused of setting up more than a dozen clinics that allegedly billed Medicare for wound care products and skin substitutes that were never provided to patients.
- A cardiologist accused of signing off on cardiovascular screening results for student athletes within seconds, without personally reviewing them, in a scheme tied to roughly $89 million in alleged billing.
- A Sarasota nurse practitioner and two additional healthcare workers accused of a wound care scheme involving more than $118 million in alleged billing for skin grafts that investigators say were unnecessary, ineligible, or never provided, some involving patients whose wounds were infected or unlikely to heal.
What This Means for Patients and Families
The Florida cases in this takedown share a common thread: patients, some of them elderly, chronically ill, or otherwise vulnerable, were allegedly given treatments and products that did not match their actual medical needs.
Federal officials specifically called out schemes involving wound care patients whose injuries were infected or unlikely to heal, situations where an unnecessary or inappropriate treatment can cause real, lasting harm.
This is where the line between fraud and malpractice becomes important. A criminal fraud case focuses on whether a provider intentionally deceived a government program or insurer for financial gain. A medical malpractice claim focuses on whether the care a patient actually received fell below the standard a reasonably careful provider would have followed, regardless of what motivated that provider’s decisions.
Fraud vs. Malpractice: A Quick Comparison
| Healthcare Fraud | Medical Malpractice | |
|---|---|---|
| Who investigates or files it | Government agencies (DOJ, HHS-OIG, state Medicaid Fraud Control Units) | The injured patient or their family, through a civil claim |
| What must be shown | Intentional deception for financial gain | A breach of the accepted standard of care that caused injury |
| Possible outcome | Fines, restitution, imprisonment | Compensation for the injured patient |
A provider involved in a fraud case may also be the subject of a separate malpractice claim, but the two are not the same thing, and one does not require the other.
Protecting Yourself and Your Loved Ones
- Ask why a specific test, product, or treatment is being recommended, and whether a more conservative option was considered.
- Request copies of test results and treatment notes, and review them rather than assuming they were reviewed thoroughly by the provider.
- Seek a second opinion before agreeing to an expensive or unusual treatment, particularly for wound care products, genetic testing, or long term therapy services.
We Are Here to Help
At Baron Herskowitz and Cohen, we believe every patient in Florida deserves competent, honest medical care. If you or someone you love was harmed because of a preventable medical error, whether or not it is connected to a case like this one, our team can evaluate your situation, explain your legal options, and help you determine the appropriate next steps.
If you have questions about a potential medical negligence claim, contact Baron Herskowitz and Cohen today for a consultation.
