Justice Department expands fraud strike force to Philadelphia, charges 19 in Medicaid scheme

The Justice Department disclosed that its Northeast Health Care Fraud Strike Force is extending operations to Philadelphia, establishing a dedicated office in the Eastern District of Pennsylvania. This expansion merges the National Fraud Enforcement Division with the district’s U.S. Attorney’s Office to target Medicare and Medicaid abuse. Nineteen defendants, comprising owners and staff of home-health agencies as well as Medicaid beneficiaries, were charged with filing fraudulent claims exceeding $4 million.

Prosecutors allege that some aides billed Medicaid while imprisoned, hospitalized, working other jobs or overseas, and that a recipient claimed extensive care despite working as a carpenter. Additional accusations involve overlapping or impossible service hours and falsified clock-in records. Pennsylvania Attorney General Dave Sunday announced a plea agreement for the final participant in a prior 21-defendant case linked to $1.7 million in false claims. The new office will coordinate with HHS’s Office of Inspector General, the FBI, DEA and other agencies.