Credit: Submitted
Two cases with Bucks County ties are part of a healthcare fraud crackdown in the region.
Federal and state authorities gathered Wednesday to announce charges against 19 people in connection with home healthcare schemes targeting Pennsylvania’s Medicaid program.
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The investigations found more than $4 million in alleged fraud.
Colin McDonald, assistant attorney general for the U.S. Department of Justice’s National Fraud Enforcement Division, told reporters that 18 of the 19 defendants were charged over the past 12 days in a coordinated crackdown.
The schemes involved home care aides who allegedly billed Medicaid for services they never provided and patients who conspired to submit fake claims.
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“To those taking advantage of home health funds that are so critical to allowing aging and ill Americans to live and receive care at home, your time is up,” McDonald said. “The era of getting rich off the backs of our programs for our sick, elderly, and disabled is over.”
U.S. Attorney for the Eastern District of Pennsylvania David Metcalf highlighted a case involving a Philadelphia personal care aide and a Medicaid recipient who allegedly schemed to defraud the program out of at least $160,000.
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Fraudulent clock-ins were submitted for care purportedly delivered while the recipient was incarcerated at the Bucks County Correctional Facility and while working at a construction job, officials said.
In another case, Pennsylvania Attorney General Dave Sunday said two personal care attendants in southeastern Pennsylvania billed nearly $1.5 million for unperformed work. One defendant worked across several places, including Bucks County.
The enforcement effort arrives as Pennsylvania’s Medicaid home care expenditures have risen dramatically since the Pennsylvania Department of Human Services launched its personal care services program in 2018. Annual billings grew from $120 million in 2019 to $2 billion in 2022 and reached $8 billion in 2025, authorities said.
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Pennsylvania ranks fifth nationally in average monthly Medicaid payments per beneficiary and per provider, with average annual payments topping $50,000 per beneficiary.
While law enforcement has targeted regional healthcare fraud for years, President Donald Trump’s administration increased attention on the issue.
The White House has put a spotlight on enforcement actions in California and Minnesota where officials deferred at least $1 billion in Medicaid payments.
Sunday, a Republican, said that Pennsylvania led the country in Medicaid fraud convictions last year. The probes secured 115 convictions and recovered approximately $41 million.
“Every dollar stolen from these programs causes direct harm to someone who needs care and cannot afford it,” Sunday said.
Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz spoke and called the schemes a “diabolical breach of trust” and a “violation of the sacred bond between patient and caregiver.”
Officials acknowledged that Electronic Visit Verification, a federal system implemented in 2020 to track care providers at service sites, has proven insufficient to stop all fraud.
Asked about safeguarding honest caregivers, Oz called them key allies in the fight against fraud.
“These fraudsters are stealing our trust,” Oz said. “And that’s a much more difficult thing to replace.”
Officials also announced an expansion of the U.S. Department of Justice’s Northeast Healthcare Strike Force.
“Fraud is not a victimless crime,” said Scott Brady, executive director of the White House Anti-Fraud Task Force. “Fraudsters steal from all of us and real people get hurt.”
The multi-agency investigations involve the U.S. Department of Health and Human Services Inspector General’s Office, state attorney general’s office, the FBI, IRS Criminal Investigation, and the Drug Enforcement Agency.
Sunday noted in June that the state’s efforts remain bipartisan, with Democratic Gov. Josh Shapiro’s administration routing fraud complaints to investigators.
“The reason why we are so successful and the reason the states that are successful are because they’re working as a team together,” Sunday previously told Fox News, adding that his office’s fraud unit recovers four times what it spends on investigations.
Pennsylvania’s Medicaid Fraud Control Unit operates on a $17.98 million budget for fiscal year 2026, with 75 percent funded by a federal grant and the remaining 25 percent covered by the state.
