Federal prosecutors have charged Erekle Gugava, a 33-year-old Georgian national who authorities say is in the U.S. illegally, with conspiracy to launder money in connection with what the Justice Department describes as the largest health care fraud case it has ever prosecuted.
Gugava allegedly served as a money launderer for a transnational criminal organization operating from Russia and elsewhere that prosecutors say targeted Medicare and other health insurers through a multibillion-dollar fraud scheme uncovered as part of Operation Gold Rush.
According to court documents, Gugava purportedly owned ND Medical Solutions LLC, a Pennsylvania durable medical equipment company, between February and July 2025. During that five-month period, the company allegedly submitted at least $1.3 billion in fraudulent claims to Medicare, Medicare supplemental insurers, employer-sponsored plans and other insurers.
Insurers paid ND Medical about $6.5 million, prosecutors said.
Federal investigators allege Gugava opened several bank accounts in the company’s name and served as the sole signatory. Insurance reimbursement checks were deposited into those accounts before the money was transferred to overseas accounts for the benefit of the criminal organization.
The fraudulent claims allegedly relied in part on stolen identities from people in Massachusetts, elsewhere in New England and across the country. Prosecutors said elderly and disabled Americans were among those whose identities were used to bill insurers for medical equipment they had not received and services involving doctors they had never visited.
Federal authorities said the scheme was particularly difficult to detect because the proceeds originated from legitimate sources, including Medicare and established insurance companies, giving the funds an appearance of legitimacy before they were moved through the financial system.
Gugava faces one count of conspiracy to commit money laundering. If convicted, he could face up to 20 years in prison.
The case is being investigated by the Department of Health and Human Services Office of Inspector General, FBI, U.S. Postal Inspection Service, IRS Criminal Investigation, Homeland Security Investigations and the Department of Labor’s Employee Benefits Security Administration.
The prosecution is being handled by the Justice Department’s National Fraud Enforcement Division and the U.S. Attorney’s Office for the District of Massachusetts.
The Justice Department said its Health Care Fraud Strike Force Program has charged more than 6,200 defendants since 2007 in cases involving more than $45 billion in alleged billings to federal health programs and private insurers.