The U.S. Justice Department building in Washington. Photo: Diego M. Radzinschi/ALM

The U.S. Department of Justice is prosecuting allegations of claim fraud against private health insurers and benefit plans, as well as against government health benefits programs.

Officials made that point Monday by including a case involving Aflac and a case involving an unnamed dental insurer on a list of "health care fraud takedown cases" that it discussed at a press conference.

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The department announced that a team of federal and state agencies is taking action against individuals accused of participating in health care fraud schemes that caused, or could have caused, a total of $14.6 billion in intended losses.

Most of the cases involved Medicare, Medicaid or workers' compensation programs. The highlight was Operation Gold Rush — an effort to bring down an international crime ring that used the stolen identities of 1 million U.S. citizens to flood Medicare with $10.6 billion in fraudulent claims for urinary catheters and other medical devices.

But officials also included a move to charge Paul Lyons of Fraser, Michigan, and Tiffany Childs of Sterling Heights, Michigan, with organizing an effort to submit about $1.4 million in claims for dental services that were not actually provided to a dental insurance company in Michigan. The name of the dental insurer was not given.

Lyons had worked at dental clinics. He and Childs used the personal information for employees at automobile manufacturing plants and the names of real dentists at the clinics where Lyons had worked to create fake claims, officials said.

The names of the dental clinics involved were not available.

Lyons and Childs could not immediately be reached for comment.

Officials also included a list of six cases involving current or former employees of the Washington Metropolitan Area Transit who allegedly used fraudulent paperwork to create fake claims for at least $362,035.14 in supplemental health insurance and short-term disability insurance benefits against Aflac.

Some of the claims included fake physicians' statements and forged physician signatures, officials said.

Representatives for Aflac were not immediately available to comment, and the defendants could not immediately be reached for comment.

News of the Justice Department prosecutions comes as private insurers and private plans have been getting more attention for their own fraud-fighting efforts.

Related: Florida women arrested in alleged $1.1M false claims case against Aetna

Elevance recently accused a group of providers of trying to overwhelm its claim administration systems by flooding it with claims under the federal No Surprises Act for out-of-network care. Also, NVIDIA, a big computer chipmaker, accused a former fraud prevention manager of defrauding its health plan.

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Allison Bell

Allison Bell, a senior reporter at ThinkAdvisor and BenefitsPRO, previously was an associate editor at National Underwriter Life & Health. She has a bachelor's degree in economics from Washington University in St. Louis and a master's degree in journalism from the Medill School of Journalism at Northwestern University. She can be reached through X at @Think_Allison.