Enforcement · March 28, 2026 · 12 min

The Government Is Going After Healthcare Fraud — Here’s What Actually Happened

By Robert Benard, MS, RN, CNS, AGACNP-BC, PMHNP-BC

Between January and April 2026, the federal government launched a fraud task force, published a sweeping RFI on healthcare enforcement, suspended hundreds of providers, and arrested hospice operators in two major busts — while pardoning convicted nursing home operators. Here is the full timeline, sourced from federal records.

What This Post Covers

This is the first in a four-part series tracking the federal healthcare fraud enforcement surge of 2026. This post lays out the timeline — what happened, when, and where the public records are. The next three posts will follow the data: where convicted operators’ facilities ended up, who is running them now, and what the enforcement numbers look like across 14,713 Medicare-certified skilled nursing facilities.

Every date, dollar figure, and claim below links to a primary source — a federal register notice, a White House fact sheet, a DOJ press release, an OIG report, or CMS data. Nothing here is editorial. The timeline speaks for itself.

The Background: CMS Was Already Cracking Down Before the Task Force

Before the executive orders and press conferences, CMS had already escalated enforcement throughout 2025. According to a legal analysis by Foley Hoag, CMS reported the following enforcement actions in 2025 alone:

  • Suspended $5.7 billion in suspected fraudulent Medicare payments
  • Denied 122,658 Medicare claims for unnecessary items and services
  • Revoked 5,586 providers and suppliers from the Medicare program
  • Sent 372 fraud referrals encompassing $3.7 billion in billing to law enforcement
  • Launched the CMS-State Tax Fraud partnership with 28 states and the US Virgin Islands

Separately, the HHS Office of Inspector General reported that Medicaid Fraud Control Units across all states secured 1,185 criminal convictions (856 fraud, 329 abuse and neglect), 674 civil settlements, and approximately $2 billion in total recoveries in FY2025 — returning $4.64 for every dollar spent on enforcement. Of note: personal care service attendants led all categories with 326 fraud convictions, and 368 active criminal and civil cases were open against assisted living facilities. (McKnight's coverage of OIG MFCU Annual Report, March 24, 2026)

This was before the task force existed.

The Timeline

November 2025: The Schwartz Pardon

On November 2025, President Trump pardoned Joseph Schwartz, the founder of Skyline Healthcare, after Schwartz had served approximately three months of a three-year federal sentence for $38 million in tax fraud. Schwartz had operated as many as 100 nursing homes across 11 states before the chain collapsed in 2018–2019, leaving residents displaced and staff unpaid. Health officials in at least six states seized or transferred control of Skyline facilities. Those facilities are still operating under new ownership — this former Skyline facility in Pennsylvania, for example, currently holds a 1-star CMS rating. (Skilled Nursing News, November 2025)

Schwartz was not the first nursing home operator to receive executive clemency. In 2020, President Trump commuted the sentence of Philip Esformes, a Florida nursing home owner convicted in what the DOJ described as the largest healthcare fraud case ever charged, involving approximately $1.3 billion in fraudulent Medicare and Medicaid claims. In December 2024, President Biden commuted the sentence of James Burkhart, the former CEO of American Senior Communities, convicted in a $19.4 million fraud and kickback scheme across Indiana nursing homes. (ProPublica, March 30, 2026; Skilled Nursing News, February 4, 2026)

These pardons are relevant to the enforcement timeline that follows. The facilities these operators once controlled are still operating. Later posts in this series will trace where those facilities went using CMS ownership data.

January–February 2026: The Fraud Task Force Takes Shape

In January 2026, Vice President Vance announced a new DOJ division dedicated to national fraud enforcement. The same month, California Governor Newsom reported that the state had revoked more than 280 hospice licenses over the preceding two years and formed a state-level fraud task force. (Hospice News, January 28, 2026)

In February, during the State of the Union address, President Trump announced the creation of the Task Force to Eliminate Fraud. Shortly after, Vice President Vance and HHS Secretary Dr. Oz paused $259.5 million in federal Medicaid reimbursements to Minnesota, citing concerns about potential fraud in personal care and home health services.

On February 14, CMS released a provider-level Medicaid spending dataset for the first time, making state-by-state spending data publicly available. (KFF analysis)

February 25, 2026: CMS Announces CRUSH

On February 25, CMS announced a package of anti-fraud measures that included:

  • The CRUSH RFI (Comprehensive Regulations to Uncover Suspicious Healthcare) — a Request for Information asking the public how CMS should strengthen fraud detection and program integrity across Medicare and Medicaid
  • A moratorium on new DMEPOS (durable medical equipment) supplier enrollments in fraud-prone areas
  • The formal Minnesota Medicaid funding deferral

HHS Secretary RFK Jr. described the shift as moving from a model of “pay and chase” to one of “detect and deploy.” The CRUSH RFI was officially published in the Federal Register on February 27, 2026 (91 FR 9803, file code CMS-6098-NC) with a 30-day comment window. (Foley Hoag legal analysis; Morgan Lewis legal analysis)

March 2026: The Executive Order and 768 Public Comments

On March 16, President Trump signed an executive order formally establishing the Task Force to Eliminate Fraud, with Vice President Vance as chair. The task force's scope covers fraud across all federal programs, not just healthcare. (White House fact sheet)

On March 27, the task force held its first formal meeting, attended by Vice President Vance, FTC Chair Ferguson, Stephen Miller, and approximately half the Cabinet.

On March 30, the CRUSH RFI comment period closed. 768 comments were submitted to the public docket (CMS-2026-0826). For context, most CMS Requests for Information receive far fewer responses. I submitted one of those comments, drawing on facility-level data from all 14,713 Medicare-certified SNFs. The full text of that comment is published here.

The same day the comment period closed, ProPublica published a detailed investigation into the Joseph Schwartz pardon and the Skyline Healthcare collapse, tracing what happened to the residents and facilities Schwartz left behind. (ProPublica, March 30, 2026)

April 1, 2026: New Assistant Attorney General for Fraud

Colin McDonald was sworn in as the new Assistant Attorney General for national fraud enforcement on April 1, heading the DOJ division announced in January.

April 2, 2026: Operation Never Say Die

On April 2, the FBI executed raids across Southern California in Operation Never Say Die. Eleven defendants were charged in nine separate investigations involving more than $50 million in alleged fraudulent hospice billing. The charges described a pattern: providers recruiting beneficiaries who were not terminally ill, paying them cash and offering free goods, then billing Medicare for hospice services never rendered. Non-death discharge rates above 70% were common across the charged providers. One defendant was already serving a federal prison sentence from a prior hospice fraud conviction in Seattle. (CNN, April 3, 2026; Fox News)

The same day, provider suspensions in the Los Angeles area hit 221 — a 215% increase from the initial 70 suspensions announced on March 25.

April 9, 2026: Operation Skip Trace and the $6.3 Billion Flag

On April 9, California Attorney General Rob Bonta announced Operation Skip Trace — a state-led case charging 21 suspects with $267 million in Medi-Cal hospice fraud. The case involved 130 shell companies, cryptocurrency laundering, dark-web identity purchases, and patients who were described as healthy, out of state, and completely unaware they had been enrolled in hospice. Bonta described it explicitly as a California case, built from state-level investigation. (ABC30)

The same day, the federal Task Force to Eliminate Fraud reported that it had flagged $6.3 billion in federal contracts across 392 potentially fraudulent businesses government-wide — not limited to healthcare.

The Hospice Problem in Context

The Southern California hospice fraud pattern did not emerge in 2026. ProPublica and the New Yorker documented the explosion of fraudulent hospice providers in California, Arizona, Nevada, and Texas in a 2022 investigation. In August 2023, CMS announced enhanced oversight for new hospice providers in those four states, including pre-pay review requirements. By 2024, ProPublica reported that 15 new hospices had received Medicare certification from a single two-story building in Los Angeles, despite a California state moratorium on new hospice licenses that Governor Newsom signed in 2021. The gap between state licensing (controlled by Sacramento) and federal Medicare certification (controlled by CMS) allowed new providers to keep entering the market. (ProPublica, 2022; ProPublica, 2024)

The scale of the problem in Los Angeles County specifically: the county went from 109 hospice centers in 2010 to more than 1,800 by 2021. Dr. Oz visited Van Nuys Boulevard, where 42 hospice licenses were registered on four blocks. A state assemblymember cited 197 agencies registered to a single building. Approximately 18% of all national home health and hospice Medicare billing came from LA County alone.

On March 23, 2026, the House Oversight Committee sent a letter to Governor Newsom demanding documentation on the state's hospice oversight, with a response deadline of April 6.

The Nursing Home Side: What the Data Already Shows

The enforcement activity described above is concentrated in hospice and home health. But the CRUSH RFI explicitly asks about program integrity across all Medicare and Medicaid provider types, including skilled nursing facilities. And the pardons that bookend this timeline involve convicted nursing home operators.

OversightReports.com tracks enforcement data for all 14,713 Medicare-certified skilled nursing facilities in the United States, drawn from 18 federal data sources. A few aggregate numbers that are relevant to the CRUSH conversation:

  • Hundreds of millions of dollars in CMS civil money penalties appear across current penalty records. Browse facility-level penalty data
  • 5,005 facilities (34.0%) reported at least one day with zero bedside registered nurse hours in Q3 2025, derived from CMS Payroll-Based Journal data. Federal law requires at least 8 consecutive hours of RN coverage per day (42 CFR 483.35(b)). The OIG recommended in June 2025 that CMS flag RN staffing violations using this data. CMS declined, citing resource constraints. This Indiana facility reported zero bedside RN hours on 67% of days in Q3 2025.
  • $11.26 billion in related-party transactions reported across 13,324 facilities on HCRIS cost reports (Worksheet A-8). These are payments from facilities to commonly owned management companies, therapy vendors, and real estate entities. They are disclosed annually on federal cost reports but not systematically monitored at the chain level. A single facility can report millions in related-party payments — this 1-star Florida nursing home, for example, reported $4.35 million in a single year.
  • The OIG published two reports on March 19, 2026 confirming that nursing homes are inappropriately diagnosing residents with schizophrenia to mask antipsychotic drug use and inflate star ratings. OversightReports.com displays facility-level antipsychotic prescribing rates for all 14,713 SNFs. I wrote to the OIG's Deputy Inspector General four days after those reports were published, sharing how this platform makes those findings accessible at the facility level. Read that letter here.
  • 599 ownership groups mapped with chain-average CMS star ratings and chain-average civil money penalties. Chain-level enforcement patterns are invisible when facilities are examined one at a time. Browse ownership groups and their facility portfolios here.

On June 24, 2026, CMS will begin publishing facility-level civil money penalty data on Care Compare for the first time. That date marks the first time families will be able to see which facilities have been fined, and how much, without filing a FOIA request or using a tool like this one. A post on that data will follow in real time.

What Comes Next in This Series

The enforcement surge and the pardons raise a question that is better answered with data than with opinions: what actually happened to the facilities these operators controlled?

The next three posts trace the data:

  • Post 2: Where Skyline Healthcare's 56 nursing homes ended up after Joseph Schwartz's conviction and the chain's collapse — which successor operators took them over, and what the enforcement record looks like at those facilities today
  • Post 3: What CMS ownership records show about former Skyline personnel still listed in active facility management roles, and about Schwartz family members with current ownership interests
  • Post 4: How American Senior Communities, the Indiana chain whose former CEO was convicted and pardoned, is operating today across 89 facilities

Every claim in those posts will link to a CMS data source, a facility page on OversightReports.com, or a public government record. The data is there. The purpose of this series is to make it navigable.

Source Index

All primary sources referenced in this post: