The US Treasury Department has identified approximately $17.5 billion in suspicious financial activity potentially linked to health care fraud, highlighting the scale of suspected schemes targeting government and private insurance programmes.
The findings come from an analysis by the Treasury's Financial Crimes Enforcement Network (FinCEN), which examined 5,702 reports filed by financial institutions under the Bank Secrecy Act between March 1, 2025, and February 28, 2026.
The reports flagged activity potentially involving Medicare, Medicaid and private health insurance, providing investigators with financial information that could help identify individuals and businesses suspected of exploiting healthcare programmes.
Treasury Secretary Scott Bessent said reports submitted by banks and other financial institutions were giving law enforcement important information about potentially illicit activity.
FinCEN Reviews 5,702 Reports
FinCEN's analysis covers reports submitted over a 12-month period under the Bank Secrecy Act.
The documents are known as suspicious activity reports, which financial institutions are required to file when transactions or financial behaviour raise potential money-laundering or other criminal concerns.
The $17.5 billion figure represents the value of suspicious activity identified in the reports. It does not mean that $17.5 billion has been conclusively proven to be fraudulent.
Investigators must separately establish whether individual transactions or schemes involved criminal conduct.
Medicare and Medicaid Targeted
The suspected activity covered multiple healthcare payment systems.
FinCEN identified transactions involving Medicare, Medicaid and private health insurance, with some potentially fraudulent payments involving more than one healthcare programme.
Medicare payments identified in the reports frequently passed through Medicare Administrative Contractors, while Medicaid-related payments generally involved state-level administrators.
The findings demonstrate the complexity of healthcare fraud investigations, particularly when suspected schemes involve multiple providers, insurers and payment channels.
Banks Provide Key Intelligence
Banks and other depository institutions accounted for the overwhelming majority of reports reviewed by FinCEN.
They submitted approximately 89 per cent of the reports included in the analysis and represented nearly 87 per cent of the reported suspicious-activity value.
Financial institutions play a critical role in identifying unusual transactions because they can detect patterns involving payments, transfers and movement of funds that may not be immediately visible to healthcare regulators.
Treasury officials said this financial intelligence can help law enforcement trace money and identify networks potentially involved in fraudulent activity.
Suspicious Activity Across US
The suspected activity was not concentrated in one part of the country.
FinCEN said financial institutions identified subjects associated with suspicious activity in all 50 states, as well as Puerto Rico, Guam and the US Virgin Islands.
The analysis involved approximately 13,000 addresses connected to subjects named in the reports.
Only around 1.5 per cent of those addresses were located outside the United States, according to FinCEN.
The figures indicate that the suspected activity identified in the analysis was overwhelmingly connected to US-based individuals or entities.
Home Health Care Leads
Among healthcare providers identified in the suspicious activity reports, home health care businesses were the most frequently cited category.
They accounted for approximately 20 per cent of reports in which a healthcare provider was identified.
Other provider categories mentioned in the analysis included hospice organisations, mental and behavioural health providers, addiction treatment facilities, medical equipment suppliers and adult and child day-care businesses.
The wide range of providers shows that suspected healthcare fraud can occur across different parts of the healthcare system rather than being confined to a single type of service.
Where Money Went
FinCEN also examined how suspected proceeds were used after payments were received.
According to the analysis, some funds were used for personal expenses and luxury purchases, while other money was transferred outside the United States.
Such transactions can provide investigators with potential evidence of how proceeds from suspected fraud are moved or concealed.
Financial institutions' reports can therefore help authorities follow the flow of money after suspicious healthcare payments enter bank accounts.
Law Enforcement Gets New Leads
Treasury officials say the analysis could help federal and state authorities identify individuals and businesses involved in suspected healthcare fraud.
Bessent said financial institutions had provided law enforcement with “critical insight” into people and entities allegedly exploiting US healthcare benefit programmes.
The findings are particularly significant because healthcare fraud can involve complex networks of providers, intermediaries and financial accounts.
However, the Treasury analysis should not be interpreted as proof that every transaction or entity identified in the reports committed fraud. Suspicious activity reports are investigative leads, not findings of guilt.
The latest assessment nevertheless gives authorities a detailed picture of financial patterns associated with suspected healthcare fraud and could support future investigations into schemes affecting public and private insurance programmes.
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