The new federal mandate.
On March 16, 2026, President Trump signed an executive order creating the Task Force to Eliminate Fraud within the Executive Office of the President. The order coordinates eleven federal departments — DOJ, HHS, Treasury, Agriculture, Labor, HUD, Education, Veterans Affairs, Homeland Security, and others — in a unified strategy to protect federal housing, food, medical, cash assistance, and other benefit programs from fraud, waste, and abuse.
The mandates carry hard deadlines: each member agency has 30 days to identify its highest-risk fraud transactions; 60 days to coordinate adoption of minimum anti-fraud controls including screening, identity verification, and pre-payment integrity checks; and 90 days to submit a measurable implementation plan. Federal funds may be withheld from jurisdictions that fail to meet anti-fraud requirements. The DOJ’s new Division for National Fraud Enforcement, activated in January 2026, centralizes federal fraud prosecution. CMS has imposed a nationwide temporary moratorium on new DMEPOS enrollments, one of the highest-risk provider categories for Medicare fraud.
The fraud landscape.
Fraud networks operating against federal benefits programs now employ the same structural sophistication used by transnational organized crime: layered corporate ownership designed to defeat standard screening, “phoenix” companies that reconstitute under new identities following enforcement actions, and nominee operators who provide human cover for criminal enterprises with no legitimate business purpose. Estimates from federal oversight bodies and academic researchers point to annual losses ranging from $100 billion to more than $500 billion across Medicare, Medicaid, and other federal benefit programs.
Five recurring architectural patterns surface across enforcement cases:
- Beneficial owner concealment — multi-layered corporate structures including shell companies, nominee operators, and international holding entities in low-transparency jurisdictions.
- Phoenix companies — criminal networks reconstitute under new entity names after enforcement, often at the same address with overlapping officers, exploiting the lag between exclusion and re-screening.
- Address clustering — dozens or hundreds of ostensibly independent businesses registered at a single commercial address, visible only through network-level analysis.
- Nominee operators — individuals appearing as owners or officers across many unrelated entities, providing human cover with no independent professional footprint.
- Exclusion circumvention — excluded individuals continue receiving federal payments through newly formed entities, associated parties, or nominee cover.
Operation Gold Rush.
In June 2025, the U.S. Attorney’s Office for the Eastern District of New York indicted eleven members of a Russia-based transnational healthcare fraud and money laundering scheme — the largest healthcare fraud case by loss amount ever recorded by the DOJ. The network purchased medical equipment companies using nominee owners, submitted more than $10.6 billion in fraudulent Medicare claims using stolen patient data, and funneled proceeds through international shell companies.
Sayari analysis extends the case far beyond the eleven indicted defendants. Georgia Secretary of State records identify Jason Onoufrienko, one of the indicted defendants, as an officer of Main Street DME Inc. Alabama records link him to Express Healthcare Inc. Sayari graph analysis then surfaces a connection through Main Street DME to two individuals who founded sixteen Florida-based healthcare companies between 2020 and 2025 — all sharing one of two small office addresses, all maintaining active National Provider Identifier (NPI) numbers, most lacking maintained websites or verifiable operational footprints, and several with ostensible CEOs whose only presence in corporate records is on these entities. This analysis — which would take investigators months through manual record review — was generated in hours.
Los Angeles hospice fraud.
Hospice fraud is one of the most acute and rapidly escalating Medicare fraud threats in the United States. A 2022 California State Auditor report found a 1,500% increase in hospice companies in Los Angeles County since 2010 — six times the national average relative to the elderly population. The typical LA County hospice billed Medicare roughly $29,000 per patient, more than double the national average of $13,200. One Los Angeles hospice targeted by April 2026 federal action reported a 97% patient survival rate against the roughly 20% national norm.
Sayari analysis of California Secretary of State records, PPP loan recipient data, the SBA Dynamic Small Business database, and USPTO trademark applications identified more than 270 hospice businesses registered within roughly eight blocks of a single street in Van Nuys. At least 250 share addresses at the same Friar Street office building, which lists only 62 suites. Across the network, individuals appear as directors of as many as 23 separate hospice entities. The director of Van Nuys-based Caring Nurses Hospice Inc. is also director of at least eighteen other hospices spread across Los Angeles, Glendale, and Las Vegas. A small number of highly-networked individuals control disproportionate shares of the cluster — the structural signature of mass incorporation, a recognized red flag for healthcare fraud.
Excluded providers, ongoing payments.
The HHS OIG List of Excluded Individuals and Entities (LEIE) contains more than 75,000 records — individuals and entities formally barred from participation in Medicare, Medicaid, and all other federal health care programs. No payment may be made for any items or services furnished, ordered, or prescribed by an excluded party, regardless of who submits the claim. Yet excluded providers continue receiving federal payments through new entity formation, employment by associated parties, nominee cover, and jurisdictional gaps between federal and state exclusion lists.
Sayari analysis comparing SAM and LEIE exclusions data with HHS Medicaid payments from 2018 through 2024 surfaced 2,228 payment records to excluded entities that occurred after those entities were added to the exclusion list. One provider continued receiving Medicaid payments for more than ten years after its exclusion, accumulating $8.9 million in disbursements. The provider’s mailing address was a P.O. box; its physical address was a residential property in Kansas, with no evident business location. Network-level exclusion screening — starting from a known excluded entity and identifying associated entities through shared officers, addresses, agents, and ownership connections — closes a gap that current entity-by-entity screening cannot.
Sayari’s Commercial World Model resolves 10.6B+ primary-source records across 250+ jurisdictions, with AI-enabled network analysis that automatically surfaces shared officers, addresses, and ownership connections. Network maps generated in hours, not months — critical for the Task Force’s 30-day risk assessment mandate. Historical records detect phoenix companies. Integration with exclusion, sanctions, and adverse-records databases closes the gap between entity-level screening and network-level fraud. Publicly available commercial records create releasable, unclassified intelligence products for prosecution and intelligence sharing.