Philadelphia: 19 Defendants Charged in Alleged $4 Million Medicare, Medicaid Fraud

Philadelphia: 19 Defendants Charged in Alleged $4 Million Medicare, Medicaid Fraud

The Justice Department’s National Fraud Enforcement Division, U.S. Attorney’s Office, and Pennsylvania Attorney General charged 19 defendants in three cases for allegedly participating in Medicare and Medicaid fraud totaling around $4 million.

The defendants include “company owners, home health aides, and Medicaid recipients, including individuals with significant criminal records.”

“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 Assistant Attorney General Colin M. McDonald of the Justice Department’s National Fraud Enforcement Division. “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.”

Four defendants, two aides and two Medicaid recipients, face accusations of conspiring “to submit claims for home health services that never occurred.”

The alleged fraud totaled $440,000 in Medicaid claims.

In one case, the DOJ pressed charges against a father and son after the son posed as an aide and claimed he provided services, but he actually drove “for a ride-share and food delivery service.”

Another case involved a Medicaid recipient who claimed that “he needed dozens of hours of home health service assistance.” However, he worked as a carpenter during the day.

Authorities discovered, through social media posts, that one supposed aide was vacationing in Miami, FL, “while he billed for providing home care services to a Medicaid recipient in the Eastern District of Pennsylvania.”

It’s insane (emphasis mine):

In one case, the Pennsylvania Attorney General charged a purported home health aide Griffin who claimed to have provided services to up to seven Medicaid recipients at once. On over 1,100 occasions, the defendant allegedly claimed to have provided care for more than 24 hours in a single day, totaling over 64,000 hours that could not have been worked. As alleged, Medicaid paid over $1.2 million as a result of the scheme. Another defendant Johnson who was charged in today’s announcement, a purported aide, claimed to have worked over 8,700 overlapping hours. As alleged, there were nearly 400 days on which the defendant claimed to be working for more than 24 hours in a day. The defendant allegedly caused over $180,000 in loss to Medicaid. In another case, a defendant Grier was charged who claimed to have provided over 1,300 hours of home care services for a Medicaid recipient who was himself incarcerated on state drug charges. A defendant in one case Murray was captured on a recorded conversation stating that “this home health care is the best kept secret . . . 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.”

There’s so much more, too. Just mind-boggling.

“This criminal conduct is much more than someone ‘working the system’ — the impact is deep and wide-ranging, as every dollar diverted deprives someone in need of care,” Pennsylvania Attorney General Dave Sunday said. “In collaboration with our partners, my office last year convicted more than 100 defendants, and clawed back more than $40 million that was intended for Pennsylvanians in need.”

McDonald also announced that the Northeast Healthcare Strike Force will expand to Philadelphia.

“We will no longer tolerate fraud against our most vulnerable citizens and our most important health programs,” said McDonald. “And to anyone engaged in healthcare fraud of any kind, of any size: we see you, and we are doing everything we can to bring you to justice. The era of getting rich off the backs of our programs for our sick, elderly, and disabled is over.”

The Northeast Health Care Fraud Strike Force has now expanded to Philadelphia!

"We are proud to join in partnership with U.S. Attorney Metcalf for @USAO_EDPA to ramp up our collective efforts to root out fraud here in Philadelphia and across Pennsylvania. This remains the early… pic.twitter.com/YmX2mS6pCX

— National Fraud Enforcement Division (@DOJFraudDiv) August 4, 2026

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