Justice Department Expands Health Care Fraud Strike Force to Philadelphia

The Justice Department has announced the expansion of its Northeast Health Care Fraud Strike Force to Philadelphia. This move targets alleged Medicare and Medicaid fraud related to home health care services.

A new strike force office will be established in the Eastern District of Pennsylvania. The effort involves the Justice Department’s National Fraud Enforcement Division and the U.S. Attorney’s Office for the district.

Federal and Pennsylvania authorities have charged 19 defendants in connection with schemes involving over $4 million in claims to Medicare and Medicaid. These defendants include owners and employees of home health care companies, supposed aides, and Medicaid recipients.

Pennsylvania Attorney General Dave Sunday announced a plea agreement involving the last defendant in a previously charged 21-defendant case linked to over $1.7 million in claims.

Fraudulent Actions and Allegations

The cases allege that some home health aides billed Medicaid for services while incarcerated, hospitalized, employed elsewhere, or traveling overseas. In one case, a Medicaid recipient claimed to need extensive home health assistance while employed as a carpenter.

Other defendants allegedly submitted claims for overlapping or impossible work hours exceeding 24 hours of care in a day. One agency and its owners faced charges for false clock-ins and clock-outs.

The expanded strike force will collaborate with the HHS Office of Inspector General, FBI, DEA, and other agencies.

Background on Healthcare Fraud Enforcement

The DOJ states that the expansion into the Eastern District of Pennsylvania will bolster resources to combat health care fraud. The partnership aims to uncover and prosecute fraudsters who misuse corporate structures for criminal activities.

The expansion follows previous additions to the strike force program in several states and actions involving billions in alleged losses.

Alexandria Hoff, a general assignment reporter for FOX News Channel, continues her investigative work on this topic.