The Justice Department has charged a Pakistani national who allegedly orchestrated a $650 million fraud scheme that primarily targeted an Arizona Medicaid program offering addiction treatment and other services for Native Americans.

Court papers say the defendant, Farrukh Ali, conspired with at least 41 substance abuse clinics to bill the state for hundreds of millions of dollars for substance abuse services that were never provided, not provided as billed or were medically unnecessary. Many of the patients who were enrolled — but not given legitimate treatment — were recruited from the homeless population or Native American reservations, officials say.

The Ali indictment is one of nearly 200 federal cases that the department announced Monday as part of its 2025 national health care fraud takedown. The effort is part of the department's long-running campaign to combat fraud in the health care sector, which officials estimate at around $300 billion per year.

This year's takedown involved $14.6 billion in intended losses, making it the largest health care fraud takedown in department history, officials said.

"Today marks a decisive moment in our fight to protect American taxpayers from fraudsters, and to defend the integrity of America's health care system," said Matthew Galeotti, the head of the department's Criminal Division.

"These criminals didn't just steal someone else's money. They stole from you," he added. "Every fraudulent claim, every fake billing, every kickback...

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