Fraud Task Force, DOJ Prosecute Half-a-Billion Dollars in Health Care, COVID Schemes

Officials estimate that fraudsters steal up to $300 billion annually from various government programs nationwide.

The Department of Justice building in Washington on March 11, 2026. Madalina Kilroy/The Epoch Times

The Department of Justice (DOJ) announced three separate criminal and civil actions on April 7 seeking to hold two individuals and two companies accountable for schemes to steal more than $500 million from taxpayer-funded programs.

The defendants are two companies implicated in an Affordable Care Act (ACA) fraud scheme, a California man pleading guilty to medication reimbursement fraud, and a Nevada woman sentenced to prison for COVID-19 tax credit fraud, the department said in an April 7 statement.

The DOJ said its efforts support President Donald Trump’s Task Force to Eliminate Fraud, chaired by Vice President JD Vance, which aims to clean up federal benefit programs.

“Thanks to the leadership of President Donald Trump, the Department, working closely with the Task Force to Eliminate Fraud, is supercharging efforts to take down every fraudster and bring them to justice,” Acting Attorney General Todd Blanche said.

“In one day, the Department prosecuted the theft of a half-billion in taxpayer dollars. All those ripping off the American people are on notice.”

Obamacare Scheme

One case involves insurance brokerage company AP of South Florida LLC (APSF), which is accused of fraudulently enrolling thousands of vulnerable people into fully federally subsidized ACA plans, also known as Obamacare. The scheme resulted in the federal government paying $141.5 million in unwarranted subsidies.

APSF targeted vulnerable, low-income people who were unemployed, homeless, or experiencing mental health and substance abuse disorders. Most of them did not meet the minimum eligibility requirements for ACA subsidies.

“As a result of being enrolled in subsidized ACA plans for which they did not qualify, some of these consumers experienced serious disruptions in their medical care or prior insurance coverage under Medicaid or other programs,” the DOJ said.

The government has filed criminal and civil cases against APSF, with the company pleading guilty to engaging in the fraudulent scheme.

AssuredPartners Inc., a national partnership of insurance brokers and the former parent company of APSF, agreed to pay multimillion-dollar fines to resolve the allegations.

In an earlier DOJ crackdown, the president of an insurance brokerage company and the chief executive of a marketing company were sentenced to 20 years in prison for a similar $233 million fraud scheme related to the ACA.

Medication Reimbursement Fraud

Authorities charged Paul Randall, of Orange, California, with submitting almost $270 million in fake claims over 11 months to Medi-Cal, California’s Medicaid program.

Randall, 66, worked with multiple co-conspirators to exploit Medi-Cal’s temporary suspension of a requirement in 2022 that had required health care providers to obtain prior authorization before offering certain medications. Medi-Cal had temporarily suspended this mandate while transitioning to a new payment system.

Together with his co-schemers, Randall billed Medi-Cal millions of dollars per month for dispensing high-reimbursement drugs that actually contained cheap, generic ingredients. For instance, the schemers billed roughly $13,424 for a generic drug that usually costs just $5 to $25 for a 30-day supply.

Randall has pleaded guilty to a count of wire fraud and is facing a maximum jail term of 30 years.

COVID-19 Tax Credit Fraud

A Nevada woman, Candies Goode-McCoy, together with other conspirators, defrauded the United States of almost $100 million in COVID-19-related employment tax credits, the DOJ said.

These credits were set up by Congress to provide support to struggling businesses during the pandemic period.

“From approximately June 2022 through September 2023, McCoy filed more than 1,200 tax returns for her own businesses and those of others, which falsely claimed these credits and sought refunds totaling more than $98 million,” the DOJ said. “In total, the IRS paid out approximately $33 million as a result of the scheme.”

McCoy was sentenced on April 6 to 54 months in prison and three years of supervised release.

Task Force to Eliminate Fraud

The Task Force to Eliminate Fraud was set up by Trump via a March 16 executive order. In addition to  Vance as its head, the task force has Federal Trade Commission Chairman Andrew Ferguson serving as vice chair.

“This is a very big thing that we’re doing,” Trump said at the time. “The kind of money we’re talking about is country-changing.”

Officials estimate that fraudsters steal up to $300 billion annually from various government programs nationwide.

According to a March 16 White House fact sheet, Trump’s order directs the task force to come up with a national strategy to stop fraud, abuse, and waste across federal benefit programs, including those covering food, medical care, housing, and cash assistance.

In an April 7 post on X, an official White House account said that authorities are currently dealing with more than 8,000 fraud cases.