Federal Authorities Charge 19 in Philadelphia-Based Medicare, Medicaid Fraud Scheme Worth $4 Million

The Department of Justice announced Tuesday that it is establishing a strike force office in the Eastern District of Pennsylvania to combat Medicare and Medicaid fraud related to home health care services. The expansion represents a significant federal enforcement effort in the region and will combine resources from the Justice Department’s National Fraud Enforcement Division with the U.S. Attorney’s Office for the district.

Nineteen defendants face charges in connection with schemes involving more than $4 million in fraudulent claims submitted to Medicare and Medicaid programs. The defendants include home health care company owners, employees, aides and Medicaid recipients, according to a DOJ statement. Additionally, Pennsylvania Attorney General Dave Sunday announced a plea agreement with the final defendant in a separate 21-defendant case involving more than $1.7 million in false claims.

The alleged schemes included home health aides billing Medicaid for services while incarcerated, hospitalized, working other jobs or traveling internationally. Prosecutors also documented cases where a Medicaid recipient claimed to require extensive home care assistance while simultaneously working as a carpenter, and defendants who submitted overlapping or impossible work schedules, including claims exceeding 24 hours of care in a single day.

The Justice Department characterized the strike force expansion as part of a broader commitment to combating health care fraud nationwide. The Philadelphia office will coordinate with the Department of Health and Human Services Office of Inspector General, the FBI, the DEA and additional law enforcement agencies in investigating and prosecuting offenses.

The establishment of the Philadelphia strike force follows recent expansions in California, Arizona, Nevada, Massachusetts and Minnesota. The DOJ noted that national health care fraud enforcement actions in 2025 and 2026 involved alleged losses exceeding $15 billion and $6 billion respectively.