The Justice Department has expanded its Northeast Health Care Fraud Strike Force to Philadelphia, announcing criminal charges against 19 defendants accused of participating in schemes that defrauded Medicare and Medicaid of more than $4 million. The expansion aims to bolster investigations and prosecute individuals involved in healthcare fraud.
The new strike force office in the Eastern District of Pennsylvania will integrate resources from the Justice Department’s National Fraud Enforcement Division and the U.S. Attorney’s Office for the district. The charged defendants include owners of home health care companies, employees, aides, and Medicaid recipients.
Allegations in the cases include home health aides billing for services while incarcerated, hospitalized, working other jobs, or traveling abroad. In one instance, a Medicaid recipient reportedly claimed extensive home health assistance while simultaneously working as a carpenter. Other defendants are accused of submitting overlapping or impossible work hours, with some claims exceeding 24 hours of care in a single day. One home health care agency and its owners face charges for allegedly billing Medicaid for falsified clock-in and clock-out times.
Pennsylvania Attorney General Dave Sunday also reported a plea agreement with the final defendant in a separate 21-defendant case involving over $1.7 million in fraudulent claims.
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. This expansion follows recent additions to the strike force program in California, Arizona, Nevada, Massachusetts, and Minnesota, and is part of broader national efforts to combat healthcare fraud, which have led to actions involving billions of dollars in alleged losses in recent years. The Justice Department stated that the strike force will utilize all available legal tools to identify, investigate, and prosecute offenses against the public.