US officials have charged 73 people over what is thought to be the largest ever attempt to defraud the country's medical insurance system. Prosecutors say a network of Armenian gangsters and their associates set up fake clinics using stolen identities to make false claims for treatment.
Investigators said more than $35m (£22m) was paid out. A US Attorney said the scheme's scope and sophistication put the traditional mafia to shame.
The group, most of whom are of Armenian origin, are accused of setting up some 118 clinics across the US, most of which existed only on paper or were "nothing more than shams, shells, and storefronts", said US Attorney Preet Bharar.
They allegedly stole the identities of real doctors and beneficiaries of Medicare - the US federal insurance programme for the elderly - and "submitted bill after bill for treatment that no doctor ever performed and that no patient ever received," he added.
In addition, the gang were accused of carrying out "a raft of rackets, extortion, credit card fraud, identity theft, immigration fraud, and even the distribution of contraband cigarettes and stolen Viagra".