I don't get why haven't they just hired more fraud investigators and people to recover proceeds then? It is laughable that the government only started to even remotely acknowledge the Medicare fraud issue in the 2000s. We are talking about tens of billions of dollars stolen every year for the past 30+ years. There are prosecutions but only in a fraction of cases because there are simply so many of them. You could even have something like the NYC Marshal system where they get a % of everything they recover. It's not hard to find pharmacies that 80% of the time prescribe expensive compounded medications that are incredibly rare in the real world or "telemedicine" doctors who are signing off on hundreds of prescriptions a day.