19 charged in $4M Medicaid fraud in Pennsylvania
Federal and state officials announced criminal charges against 19 people and a Philadelphia-based home health care company for allegedly defrauding Pennsylvania’s Medicaid program out of more than $4 million, according to the Department of Justice.
PHILADELPHIA – More than a dozen people and a home care agency in Philadelphia face federal charges for allegedly conspiring to defraud the Pennsylvania Medicaid program, according to United States Attorney David Metcalf.
Federal and state officials detail the scope of alleged fraud
What we know:
“Today we are announcing criminal charges against 19 defendants for fraudulent home healthcare schemes that targeted Pennsylvania’s Medicaid program and resulted in over 4 million dollars of fraud,” said Assistant Attorney General Colin McDonald on Tuesday.
Investigators say the accused home health aides billed for thousands of hours of services that were never provided.
The Pennsylvania Attorney General’s Office described the impact as “deep” and “wide-ranging.” Officials say the Medicaid program is designed to let trusted friends or relatives care for elderly or disabled people at home, but investigators allege the system was “systematically taken advantage of.”
One example cited involved two home health aides and two patients who allegedly caused more than $400,000 in false Medicaid claims.
“Across these cases we have home care services billed that were not rendered by aides that were dead, that were in prison, that were selling drugs. Aides that were billing over 24 hours a day repeatedly for a year,” said U.S. Attorney David Metcalf.
Investigators say the Philadelphia-based company Benevolent Home Health is also facing charges. Officials described the arrest of the company’s owner, saying, “He said everybody is doing this. If it’s a problem, you’d have to arrest the whole city. That is shocking and illustrates what we’re dealing with here.”
The schemes allegedly drained taxpayer-funded dollars from Pennsylvania’s Medicaid program, with officials emphasizing the program’s vulnerability to exploitation.
The other side:
“What we’re exposing today is a diabolical breach of trust in the sacred bond between a patient and care giver,” said Dr. Mehmet Oz, administrator for the Centers for Medicare and Medicaid Services.
“This is more than a financial crime. This is a very dangerous public safety issue and a lot of people who should be receiving help are not receiving it because of this,” said Pennsylvania Attorney General Dave Sunday.
Officials say these charges are part of a broader effort to protect Medicaid and Medicare programs from fraud.
“The era of getting rich off our programs for our sick, elderly and disabled is over,” said McDonald.
Officials say the program, when used properly, allows those with physical ailments to be cared for by trusted individuals. “Used properly by honest citizens, the program allows those with physical ailments to be cared for by those they trust the most,” said McDonald. “Infiltrated by greedy and deceitful opportunists, this program becomes a money tree.”
The charges come as authorities say they are working to end what they call the “systemic exploitation” of Medicaid. “Because no one should be able to rip off the United States or America and get away with it,” said Sunday.
What we don’t know:
Officials have not released the names of the 19 people charged or provided details about the specific charges against the Philadelphia-based company. It is also unclear what penalties those charged could face if convicted.
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