Crackdown on Medicare and Medicaid Fraud in Philadelphia: Northeast Health Care Fraud Strike Force Expands
The Justice Department has announced the expansion of the Northeast Health Care Fraud Strike Force to Philadelphia, focusing on Medicare and Medicaid fraud related to home health care services. This expansion will establish a strike force office in the Eastern District of Pennsylvania, combining the efforts of the National Fraud Enforcement Division and the U.S. Attorney’s Office for the district.
In response to the expansion, federal and Pennsylvania authorities have charged 19 defendants involved in schemes totaling over $4 million in claims submitted to Medicare and Medicaid. The defendants include owners of home health care companies, employees, aides, and Medicaid recipients. Additionally, Pennsylvania Attorney General Dave Sunday announced a plea agreement with the final defendant in a previously charged case linked to more than $1.7 million in claims.
The Fraud Division's expansion into the Eastern District of Pennsylvania aims to strengthen health care fraud enforcement in the region. The partnership between the Fraud Division and the Eastern District of Pennsylvania will enhance law enforcement efforts to combat fraudulent activities conducted through corporate entities.
The cases involve various allegations, such as home health aides billing Medicaid for services while incarcerated, hospitalized, or working other jobs. Prosecutors also highlighted instances where Medicaid recipients claimed extensive home health assistance while engaging in unrelated activities, like carpentry work. Some defendants were accused of submitting false work hours, including claims for more than 24 hours of care in a single day, and billing Medicaid for fabricated clock-ins and clock-outs.
The expansion of the Strike Force underscores the Fraud Division's commitment to using all available legal resources to investigate and prosecute offenses against the American people. The Philadelphia office will collaborate with the Department of Health and Human Services Office of Inspector General, the FBI, the DEA, and other law enforcement agencies to address health care fraud in the region.
This expansion follows recent additions to the strike force program in several states and national health care fraud enforcement actions targeting billions of dollars in alleged losses. The DOJ's efforts demonstrate a proactive approach to identifying, investigating, and prosecuting fraudulent activities that impact the healthcare system and the public.