Foreign National Indicted in Multimillion Dollar Healthcare Fraud Conspiracy

RALEIGH, N.C. - Today, United States Attorney Ellis Boyle announced criminal charges against James Thomas Foley, 45, an Irish citizen residing in Youngsville, North Carolina, in connection with a multimillion-dollar health care fraud conspiracy on Medicare and other health insurance programs involving unnecessary durable medical equipment (DME). The charges filed in federal court are part of the Department of Justice's 2026 National Health Care Fraud Takedown.

"We will focus on exposing and stopping any scheme to bill Medicare for fake services or products that beneficiaries don't actually need especially when provided in exchange for illegal kickbacks," said U.S. Attorney Ellis Boyle. "When fraudsters treat Medicare like a personal ATM, the American taxpayers foot the bill. Our partners will not tolerate this criminal activity. Cheaters. Never. Win."

The charges against Foley emanate from a scheme to bill Medicare, the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA), TRICARE, and other insurance programs for medically unnecessary DME. As alleged in the indictment, Foley and others partnered with purported marketing entities which solicited Medicare beneficiaries to accept DME, such as braces and pneumatic compression devices, by illegally waiving copays and deductibles, and pressuring beneficiaries to accept the equipment without verifying that the equipment was medically necessary. The marketing entities sold the beneficiary information and the prefilled orders to Foley and other DME supply companies, who developed and implemented a "doctor chase" model to pressure physicians into signing or altering orders so that they could be billed in full. The DME supply companies owned by or affiliated with Foley allegedly received over $14 million in reimbursements from Medicare alone. Another defendant, Randal Fenton Wood, pleaded guilty in connection with the same conspiracy last year in EDNC. Court documents and information can be found on the website of the U.S. District Court for the Eastern District of North CarolinaLinks to other government and non-government sites will typically appear with the "external link" icon to indicate that you are leaving the Department of Justice website when you click the link. or on PacerLinks to other government and non-government sites will typically appear with the "external link" icon to indicate that you are leaving the Department of Justice website when you click the link. by searching for Case No. 5:25-CR-128-FL.

"Safeguarding the integrity of federal health care programs is central to our mission, and the results of this year's National Health Care Fraud Takedown reflect the strength of our collective commitment. The cases announced today demonstrate not only the scale, but the seriousness of the misconduct uncovered, ranging from patient harming schemes to multibillion dollar fraud operations," said Department of Health and Human Services Inspector General T. March Bell. "HHS-OIG will continue to pursue those who engage in such conduct and hold them accountable. I am grateful for the tireless work of our special agents and for the partnership we share with our federal, state, and local law enforcement colleagues as we work together to protect patients and preserve public funds."

"Safeguarding TRICARE is essential to ensuring that resources remain available for our service members, retirees, and their families," said Acting Special Agent in Charge Allison Russo of the Department of Defense Office of Inspector General's Defense Criminal Investigative Service (DCIS) Mid-Atlantic Field Office. "This indictment demonstrates DCIS's commitment, together with our law-enforcement partners, to identifying and addressing conduct that threatens the integrity of the Department of War's health care programs."

"Healthcare schemes steal taxpayer dollars and divert critical resources away from the veterans who depend on them," said Inspector General Cheryl L. Mason, Department of Veterans Affairs Office of Inspector General (VA OIG). "The VA OIG will vigorously investigate anyone who seeks to defraud VA programs. We thank the U.S. Attorney's Office and our law enforcement partners for their efforts in this investigation."

On April 7, the Department of Justice announced the creation of the National Fraud Enforcement Division ("Fraud Division"). The Fraud Division is laser-focused on investigating and prosecuting those who commit fraud against the American people. The Department's work to combat fraud supports President Trump's Task Force to Eliminate Fraud, a whole-of-government effort chaired by Vice President J.D. Vance to eliminate fraud, waste, and abuse within Federal benefit programs.

Ellis Boyle, U.S. Attorney for the Eastern District of North Carolina, made the announcement. Department Health & Human Services Office of the Inspector General investigated the case with assistance from Department of Veterans Affairs Office of the Inspector General and Defense Criminal Investigative Services.

More information can be found at https://www.justice.gov/criminal-fraud/health-care-fraud-unit.

A copy of this press release is located on our website. Related court documents and information can be found on the website of the U.S. District Court for the Eastern District of North CarolinaLinks to other government and non-government sites will typically appear with the "external link" icon to indicate that you are leaving the Department of Justice website when you click the link. or on PACERLinks to other government and non-government sites will typically appear with the "external link" icon to indicate that you are leaving the Department of Justice website when you click the link. by searching for Case No. 5:26-CR-104-UA.

An indictment is merely an allegation. All defendants are presumed innocent until proven guilty.