This is an interesting case not because it was Medicare money involved in the fraud and subsequently money laundered and ended up in Cuba but because it is the pot calling the kettle black. The US government has to be the top money laundering agency in the world.
Others may launder huge amounts of money but the ownership is rather spread out among assorted gangs and individuals. However, the US government waits till individuals amass huge amounts of money and then goes after them with civil forfeitures. Not only that but they readily set up the playing field so that it takes an illegal operation to meet a demand that is insatiable.
Instead of attempting to control the quality channels of distribution through legal means essentially they decriminalize the use which legalizes the demand and go after those attempting to meet the demand. This is a racket that starts at the local city police department and echo’s up to the top law enforcement agencies of the country.