Open the Books exposed yet another insight into the stinking, rotten catastrophe that is the massive, systematic, and continuing stealing from American taxpayers via an unknown number of federal social service programs that for decades have all but hung in their windows signs saying "Come Steal."
Earlier this month, the headline on the Open the Books website proclaimed "Hidden Fees: Taxpayers on the Hook for Foreign-Linked Health Care Fraud Schemes." Here's what was found:
In January 2026, Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz alleged that roughly $3.5 billion worth of fraud, so far unconfirmed, was happening through false hospice billings in a scheme he attributed in large part to what he called the 'Russian Armenian mafia.'
So, Open the Books took a look at Oz’s claims, what fraud could be confirmed, and its cost to taxpayers. It turns out Russian and Armenian-linked fraud has cost taxpayers almost $1 billion in confirmed losses from Medicare and Medicaid, part of a Department of Justice operation dubbed 'Operation Gold Rush.'
So now we must add the Russian-Armenian Mafia to the Somali robbing of Medicaid billions in Minnesota and Ohio, and whatever ethnicity may be the thieves behind the similarly systematic filching in California and Maine. And let's not forget the Mexican Drug Cartels almost certainly have their greasy fingers in this long-running criminal enterprise, too.
Thus far, 11 individuals involved in the transnational criminal operation have been charged by the Department of Justice (DOJ) in Operation Gold Rush, which is the largest health care fraud case ever charged by federal officials. The criminals bought medical equipment firms, then submitted fraudulent Medicare claims using more than 1 million stolen Americans' names.
Only 11 people charged? There were 324 individuals charged nationwide by the DOJ last year, and the total thus far in 2026 isn't known. But let us assume DOJ doubles its 2025 level and takes 648 individuals to federal court for defrauding Medicare, Medicaid, Social Security, Veterans Affairs, SNAP/Food Stamp, and who knows how many more federal benefit programs? And we haven't even mentioned fraud in Department of Defense procurement.
Given the international scope of the waste and fraud, one might reasonably expect that thousands of criminals are involved who should be identified, charged, convicted, and imprisoned. According to GAO in 2024, the government loses as much as $521 billion annually to fraud, but expects that estimate to spiral as the DOJ's current anti-fraud effort goes forward.
Whatever the final number of individuals charged with fraud, or engineering improper payments, or committing contract fraud, that accounts for only one side of the problem. But there's another side that nobody is talking about — what is the accountability of the thousands of federal workers employed in management or operational roles by the many benefit programs?
Considering only Social Security, Medicare, Medicaid, and VA, there are more than 515,000 federal white-collar civil servants managing, administering, and operating those huge benefit programs. These people are among the most well-educated, highly skilled, and well-paid employees in America.
But there's more to this angle, including another 1,600 civil servants, many of whom are highly trained, experienced auditors and investigators, working for the Inspectors General (IG) charged with rooting out waste and fraud in all of the major federal departments and independent agencies.
Don't misunderstand my point here: I'm not suggesting all federal workers are guilty of aiding and abetting or ignoring billions of dollars in waste and fraud happening right under their noses every day. I respect and admire hard-working, dedicated civil servants because my Dad was one, and I spent nearly a decade on government payrolls before becoming a journalist.
Here's my point: At what point does the official response to the vast all-but-unchecked waste and fraud in federal spending ask this question: Why does so much fraud happen without more of it being prevented, or at least identified and referred to the DOJ, by the more than half a million civil servants working on these benefit programs?
It's not unreasonable to ask how many of these federal workers bear some portion of accountability for this scandal, either because they are actively enabling it, purposely looking the other way, or simply not caring.
There is also the question of when Congress gets the cojones to change the incentive structure of federal civil service, both to more effectively encourage and protect those who insist on higher standards of acceptable effort in the daily routine of program administration.
And speaking of Congress and cojones, why are there so many hundreds of GAO recommendations for commonsense reforms in federal programs that have been ignored for years? Political leaders in both parties bear some responsibility here, but not all of it.
I know from personal experience that political appointees often must depend upon the advice of career civil servants, and I strongly suspect that this factor explains at least some of the lack of timely, incomplete, or spiritless implementation of GAO recommendations.
Sooner or later, regardless of how many criminals are indicted and prosecuted, voters are going to ask these kinds of questions of the federal workforce and its political and career leadership. It's long past time.
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