Federal authorities have arrested a fugitive accused of orchestrating a massive $547 million Medicare fraud scheme, bringing an end to an international manhunt that lasted more than three years.

The U.S. Department of Justice announced Tuesday that Khalid Ahmed Satary, 54, was arrested in the Middle East on July 20 and extradited to the United States to face federal charges stemming from one of the largest alleged Medicare fraud operations in recent years. Satary had been on the FBI’s newly created Most Wanted Fraudsters list after fleeing the country in 2022 while awaiting trial.

Satary was first indicted in 2019 in the Eastern District of Louisiana on charges that he led a nationwide conspiracy that fraudulently billed Medicare for more than $547 million in medically unnecessary genetic tests between 2016 and 2019. According to prosecutors, the scheme relied on deceptive telemarketing campaigns, telemedicine companies, illegal kickbacks and bribes paid to physicians and patient recruiters to generate fraudulent claims, with some tests reimbursed by Medicare for as much as $20,000 each.

Federal prosecutors allege that through laboratories under his control, Satary not only submitted hundreds of millions of dollars in false claims but also paid millions in illegal kickbacks to recruit patients and medical providers. During the original investigation, authorities seized 16 bank accounts and froze several real estate properties linked to the case.

Although he was released on bond following his indictment under the condition that he refrain from working in the health care industry, prosecutors say Satary continued submitting fraudulent Medicare claims through Houston-area laboratories. After failing to appear for a scheduled court hearing in December 2022, a federal arrest warrant was issued, and investigators say he fled the United States.

When he was arrested overseas, authorities said Satary was carrying a counterfeit Mexican passport bearing a false identity. He was transported back to the United States and made his initial appearance Tuesday in federal court in the Eastern District of Virginia before being transferred to face the original charges.

Satary faces multiple federal charges, including conspiracy to commit health care fraud and wire fraud, health care fraud, conspiracy to defraud the United States through illegal kickbacks and bribery, and conspiracy to commit money laundering. If convicted on all counts, he could face decades in federal prison.

Announcing the arrest, FBI Director Kash Patel said Satary is the third suspect captured from the bureau’s Most Wanted Fraudsters list since the initiative was launched in June.

Acting Attorney General Todd Blanche said the defendant is accused of exploiting thousands of elderly and vulnerable patients while costing American taxpayers more than half a billion dollars, adding that the arrest demonstrates the Justice Department’s commitment to pursuing fugitives regardless of where they attempt to hide.