The Justice Department’s National Fraud Enforcement Division has announced charges against 19 individuals for Medicaid home health aide fraud schemes in Pennsylvania. The announcement was made in partnership with the Pennsylvania Attorney General, and the U.S. Attorney’s Office. The defendants include owners and employees of several home care companies.
A press release put out by the DOJ revealed that the individuals charged participated in various fraud schemes that resulted in over four million dollars in claims made to both Medicaid and Medicare. The final defendant in the case made a plea deal with the Pennsylvania Attorney General in a previously-charged 21-defendant case that concerned $1.7 million in claims.
“Today, we are announcing criminal charges against 19 defendants for fraudulent home health care schemes that targeted Pennsylvania’s Medicaid fraud program and resulted in over $4 million of fraud,” Assistant Attorney General for the National Fraud Enforcement Division Colin McDonald said during a press conference concerning the charges.
“Eighteen of these defendants were charged in the last 12 days as part of a strategically coordinated law enforcement operation between the fraud division, the U.S. Attorney’s Office, and the Pennsylvania Attorney General’s Office,” McDonald continued. “The cases today build on the work that we recently announced in Minnesota, where we charged 15 defendants for systematically looting seven state-managed Medicaid programs out of more than 90 million dollars.”
McDonald then said that the defendants treated those programs “like a piggy bank,” until “one of them had to be shut down entirely because there was nothing left. The shelves were empty.” He then added, “Home care funding exists to assist America’s elderly and most vulnerable — not to fund schemes in which aides claim to be providing care while incarcerated or vacationing in Miami and Saudi Arabia.”
“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,” McDonald said, according to the press release.
Centers for Medicaid & Medicare Services Administrator Dr. Mehmet Oz also spoke about the fraud schemes, saying, “Medicaid fraud robs hardworking taxpayers, deprives vulnerable Americans of the care they need, and undermines the public trust that sustains our social safety net. CMS will continue partnering with law enforcement to shut down these scams while establishing new anti-fraud safeguards that flag criminal activity before the money ever leaves the building.”
"*" indicates required fields
“This Administration is taking a whole-of-government approach to protecting Medicaid—ensuring the program serves the Americans who depend on it, not criminals seeking to exploit it,” Oz concluded. The press release then goes on to discuss how four defendants caused over $440,000 in claims to be made to the Medicaid program.
Another two defendants facing fraud charges were a father and son duo. The son, who worked as an aide, claimed to be providing services while driving a ride-share and food delivery service. The son was the subject of a traffic stop while providing these services that resulted in a citation for possession of marijuana.
Featured Image: screenshot from embedded video