The Department of Justice announced criminal charges against 19 defendants on Tuesday for allegedly defrauding Medicare and Medicaid out of more than $4 million through home care companies in Pennsylvania.
“[T]his home health care is the best kept secret,” one scammer allegedly confessed in a conversation recorded by law enforcement. “I made a buck plus [each of] the last five years, that’s, that’s a half a million dollars . . . I ain’t checking on nobody.”
At least four of the defendants ended up billing Medicaid more than $440,000 for home health services that never occurred — with one of the accused fraudsters purportedly providing care while she was in prison and another while in a hospital.
The Department of Justice announced that it is expanding the Northeast Health Care Fraud Strike Force to Philadelphia. AP Photo/Mark Schiefelbein
Other scammers bilked Medicaid dollars for services while instead they were offering “ride-share and food delivery service” or working other day jobs such as carpentry or construction.
Still others were vacationing in Miami or even located as far abroad as Saudi Arabia while supposedly offering home care services to Medicaid recipients.
And in one case, an alleged home health aide billed for more than 24 hours’ worth of care in a single day more than 1,100 times, receiving a total payout of $1.2 million for the scheme.
The announcement from authorities comes as part of the establishment of a strike force office in the Eastern District of Pennsylvania, using resources from the US Attorney’s Office there and the DOJ’s National Fraud Enforcement Division.
“Home care funding exists to assist America’s elderly and most vulnerable — not to fund schemes in which aides claim be providing care while incarcerated or vacationing in Miami and Saudi Arabia,” said National Fraud Enforcement Division Assistant Attorney General Colin McDonald in a statement.
“Today’s charges and the expansion of our Northeast Strike Force into the Eastern District of Pennsylvania send a clear message to fraudsters in the region: the Department of Justice will relentlessly pursue you and use all available tools to protect Medicaid and the programs everyday Americans rely on.”
The Philadelphia federal prosecutor’s office will work with the Department of Health and Human Services Office of Inspector General, the FBI, the DEA and other law enforcement agencies as part of the crackdown.
Pennsylvania Attorney General Dave Sunday also announced a plea agreement involving one of the defendants — who had been previously charged by state authorities in connection with more than $1.7 million in fake benefit claims.
The feds have also dispatched strike forces to California, Arizona, Nevada, Massachusetts and Minnesota.
Vice President JD Vance, in a Cabinet meeting last Friday, announced that the interagency fraud task force he oversees has already halted $56 billion in schemes bilking taxpayer dollars.
Another $230 billion worth of fraud has also been targeted.