DOJ steps up fight against healthcare fraud in Philadelphia with new specialized unit, 19 individuals charged in schemes totaling more than $4 million
The unit will work alongside the Office of the Inspector General of the Department of Health and Human Services (HHS-OIG), the FBI, the DEA, and other agencies.
Department of Justice—File Photo
The Department of Justice (DOJ) announced on Tuesday the expansion of its Northeast Health Care Fraud Strike Force to Philadelphia, in a crackdown targeting fraud against Medicare and Medicaid in home health care services. The move coincides with the filing of charges against 19 individuals for schemes totaling more than $4 million in fraudulent claims.
According to Fox News, the new Strike Force office will be established in the Eastern District of Pennsylvania and will combine the resources of the DOJ’s National Fraud Enforcement Division with the U.S. Attorney’s Office for that district. According to the Department, the expansion brings “enhanced federal resources” to a jurisdiction that already has a strong track record in prosecuting this type of crime.
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"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 unit will also work alongside the Office of the Inspector General of the Department of Health and Human Services (HHS-OIG), the FBI, the DEA , and other agencies.
Recent patterns of abuse
Those charged include owners and employees of home care companies, alleged caregivers, and Medicaid beneficiaries.
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According to Fox, authorities have identified several patterns of abuse: caregivers who billed for services while they were incarcerated, hospitalized, working other jobs, or traveling abroad; recipients who claimed to need intensive home care while working as carpenters; and claims involving impossible schedules, including shifts of more than 24 hours of care in a single day. In one case, an agency and its owners allegedly logged false clock-in and clock-out records.
Meanwhile, Pennsylvania Attorney General Dave Sunday announced a plea agreement with the last defendant in a previous case that involved 21 individuals and more than $1.7 million in claims.
The DOJ steps up the fight against healthcare fraud
The Department of Justice emphasized: "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 crackdown comes amid growing political attention to fraud in federal health care programs, an issue that has been the subject of strong criticism from the White House.
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