DOJ charges 19 defendants in alleged $4M Philadelphia Medicare and Medicaid fraud

FIRST ON FOX: The Justice Department announced Tuesday that it is expanding its Northeast Health Care Fraud Strike Force to Philadelphia as federal and state authorities target alleged Medicare and Medicaid fraud involving home health care services.

The expansion will establish a strike force office in the Eastern District of Pennsylvania and bring together the Justice Department’s National Fraud Enforcement Division and the U.S. Attorney’s Office for the district.

In connection with the announcement, federal and Pennsylvania authorities charged 19 defendants accused of participating in schemes involving more than $4 million in claims submitted to Medicare and Medicaid, according to a DOJ release obtained by Fox News. The defendants include home health care company owners, employees, purported aides and Medicaid recipients.

Pennsylvania Attorney General Dave Sunday also announced a plea agreement involving the final defendant in a previously charged 21-defendant case tied to more than $1.7 million in claims.

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"The Fraud Division’s expansion into the Eastern District of Pennsylvania brings enhanced federal resources to a district with an established tradition of strong health care fraud enforcement," the DOJ said. "The partnership between the Fraud Division and the Eastern District of Pennsylvania will uniquely enable law enforcement to combat criminals who hide behind corporations to commit fraud."

The cases include allegations that home health aides billed Medicaid for services while they were incarcerated, hospitalized, working other jobs or traveling overseas. In another case, prosecutors said a Medicaid recipient claimed to require extensive home health assistance while also working as a carpenter.

Other defendants allegedly submitted overlapping or impossible work hours, including claims exceeding 24 hours of care in a single day, according to the release. One home health care agency and its owners were also charged with allegedly billing Medicaid for false clock-ins and clock-outs.

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"The Strike Force’s expansion makes clear that the Fraud Division will use every available legal tool to identify, investigate, and prosecute offenses against the American people," the DOJ said.

The Philadelphia office will work with the Department of Health and Human Services Office of Inspector General, the FBI, the DEA and other law enforcement agencies.

The DOJ said the expansion follows recent additions to the strike force program in California, Arizona, Nevada, Massachusetts and Minnesota, as well as two national health care fraud enforcement actions involving more than $15 billion in alleged losses in 2025 and more than $6 billion in alleged losses in 2026.