In the last year, Texas has become a national focal point for aggressive healthcare fraud enforcement. Federal prosecutors and state authorities have ramped up investigations and indictments targeting physicians, medical executives, and healthcare companies accused of defrauding government programs like Medicare and Medicaid.
At Hilder & Associates, P.C., we represent healthcare professionals, executives, and organizations facing investigation or charges stemming from these complex cases. As enforcement actions grow in scope and intensity, it’s critical to understand what’s happening and how you can protect yourself.
Contact us at 713-655-9111 to learn more about how we can help.
Texas at the Center of The 2025 Nationwide Health Fraud Crackdown
In June 2025, the Department of Justice announced one of the largest coordinated healthcare fraud takedowns in U.S. history. More than 320 individuals were charged nationwide for schemes totaling over $14.6 billion in alleged fraudulent billing.
Texas was among the most heavily impacted states. In the Southern District of Texas alone, nearly 50 individuals were charged, including doctors, pharmacists, hospice operators, and lab executives. The charges included:
- $360 million in fraudulent billing
- Over 12 million pills unlawfully distributed
- Abuses of hospice, telemedicine, genetic testing, and COVID-related services
Cases involved everything from unnecessary medical procedures to illegal kickbacks and billing for services never rendered.
Fraudulent Medical Claims
One defendant from Lubbock was charged with conspiracy to commit healthcare fraud, as he was connected to the submission of fraudulent medical claims for items and services not eligible for reimbursement. His case is currently being prosecuted.
Another defendant from McKinney was charged with receiving kickbacks for referrals to certain federal healthcare programs and in connection with fraudulent claims to Medicare regarding over-the-counter COVID-19 tests. His case is also being prosecuted.
Prescription Opioid Trafficking
Earlier in 2025, over 70 defendants, including over 40 licensed medical professionals, were charged in 58 different cases in connection with prescription opioid trafficking. Allegedly, over 15 million prescription pills and other controlled substances were diverted in a massive federal operation. Five defendants from one pharmacy in Texas were charged with the illegal distribution of more than 3 million opioid pills, including hydrocodone, oxycodone, and more.
Notable Texas Cases
Houston-Area Fraud Schemes
- A group of Houston-based medical professionals was charged in a $45 million Medicare fraud scheme involving unnecessary surgeries and excessive billing.
- Another case involved an $87 million hospice scam, where patients who were not terminally ill were fraudulently enrolled for end-of-life care.
North Texas Enforcement
In the Northern District of Texas, three individuals were indicted for their roles in nearly $200 million in fraudulent claims, including:
- A McKinney lab that falsely billed Medicare for COVID and genetic testing
- A Plano provider who orchestrated an EEG kickback scheme
- Richardson clinics implicated in telehealth abuse
Other Significant Texas Enforcement Actions
- A Fredericksburg physician was sentenced for a $70 million orthotics and genetic test fraud scheme
- A Sugar Land radiology group settled False Claims Act and Anti-Kickback allegations for nearly $9 million
- A Harlingen couple pleaded guilty to submitting $14 million in false DME claims
- A Houston doctor agreed to pay $390,000 for billing Medicare for complex surgical procedures that were, in reality, acupuncture treatments
What These Cases Mean for Healthcare Providers
These enforcement actions are not isolated. They reflect a sustained commitment by federal and state agencies to crack down on perceived abuses of federal healthcare programs.
Key enforcement priorities include:
- Telemedicine and genetic testing fraud
- Hospice and home health overbilling
- Kickbacks and illegal referral arrangements
- COVID-19 testing and PPE procurement abuse
- Durable medical equipment (DME) billing schemes
Whether you’re part of a large health system or a solo practitioner, no provider is immune from scrutiny. That’s why a proactive approach to compliance and legal readiness is more important than ever.
Contact Us Today
Whether you are being investigated or believe you have uncovered fraud, do not wait to get legal advice. Time matters and so does choosing the right legal team.Reach out to us at 713-655-9111 or contact us online to discuss your case in a free consultation.
