Financial institutions flagged approximately $17.5 billion in suspicious activity related to potential health care fraud during a one-year period starting in 2025, according to a financial trend analysis released by the Financial Crimes Enforcement Network.
FinCEN analyzed 5,702 Bank Secrecy Act reports related to potential health care fraud. Depositary institutions filed nearly 87% of the reports, which accounted for roughly the same percentage of suspicious activity amounts. The two largest institutions filed more than a quarter of reports.
Perpetrators of suspected health care fraud often target more than one program or insurance provider, receiving funds from a combination of federal and state programs, as well as private insurance companies, FinCEN said. Home health care businesses were the most frequently identified health care providers in the reports.
The overwhelming majority of subjects identified in reports were based in the U.S, with only 1.5% having a foreign address.
