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GAO-25-107508 1 (2025-07-10)

handle is hein.gao/fradrkiflpms0001 and id is 1 raw text is: Why This Matters Key Takeaways Organized groups of individuals working together have defrauded public assistance programs, as was evident during the COVID-19 pandemic. Aided by technology, organized fraud groups have targeted programs at a larger volume and with greater speed than individual fraudsters. Using various fraud schemes, technology, and key information-such as stolen personally identifiable information (P1l)-organized fraud groups, both domestic and transnational, continue to pose a threat to public programs. In April 2025, we reported on fraud schemes and risks affecting federally funded assistance programs during the pandemic. This includes fraud committed both by individual opportunists and organized groups. According to our analysis of Department of Justice (DOJ) public statements and court documentation from March 2020 through December 2024, 46 percent of the 1,875 defendants convicted of pandemic fraud-related offenses with final charges recorded had conspiracy charges, suggesting involvement of an organized fraud group.1 Although the full extent of pandemic relief fraud is not known, estimates from some of the largest programs-Paycheck Protection Program (PPP), COVID-19 Economic Injury Disaster Loan Program (COVID-19 EIDL), and regular and temporary Unemployment Insurance (UI) programs-put losses around $300 billion.2 Some of these losses are associated with organized groups. For example, from January 2018 through May 2021, a hospice owner and a conspirator filed fraudulent claims and paid kickbacks to steal over $9 million from Medicare. The group carried out additional schemes to obtain fraudulent funds from three pandemic relief programs-the Provider Relief Fund, PPP, and COVID-19 EIDL. The CARES Act includes a provision for us to monitor and oversee the federal government's efforts to prepare for, respond to, and recover from the COVID-19 pandemic.3 This report provides information on organized fraud risks to public programs, including pandemic-relief programs, and agencies' roles in preventing and detecting such fraud. Organized fraud groups vary in size, structure, and participants and have defrauded programs on a large scale using technology, program knowledge, and other means. These groups harm people, programs, and society in financial and nonfinancial ways that deplete program funds and cause physical and psychological harm. Program managers, oversight and payment integrity entities, and law enforcement across the government have roles in preventing, detecting, and responding to organized fraud and use a range of data analytic tools to do so. Page 1 GAO-25-107508 Organized Fraud Page 1 GAO-25-107508 Organized Fraud

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