Federal and Pennsylvania state authorities charged 19 defendants in connection with home health care fraud schemes that allegedly billed Medicare and Medicaid for more than $4 million in fake services, including claims submitted by aides who were incarcerated, hospitalized, overseas, or even dead at the time they were supposedly providing care.
The charges arrived alongside the Justice Department’s announcement that it is expanding its Northeast Health Care Fraud Strike Force into Philadelphia, establishing a new office in the Eastern District of Pennsylvania. The DOJ’s Fraud Division will partner with the U.S. Attorney’s Office there, along with the HHS Office of Inspector General, the FBI, and the DEA.
The scope of the alleged fraud is brazen. Defendants include home health care company owners, employees, purported aides, and Medicaid recipients themselves. The billing schemes weren’t subtle accounting errors. They were, according to prosecutors, physically impossible.
The DOJ release, first obtained by Fox News, described aides allegedly billing Medicaid for home health services while they were locked up, hospitalized, working other jobs, or traveling abroad. Some defendants submitted claims for overlapping or impossible work hours, including billing for more than 24 hours of care in a single day.
One home health care agency and its owners were charged with allegedly billing Medicaid using false clock-ins and clock-outs. In another case, a Medicaid recipient who claimed to need extensive home health assistance was allegedly working as a carpenter at the same time.
U.S. Attorney David Metcalf, as reported by Breitbart, laid out the raw details in blunt terms:
“We have home healthcare services that were billed by aides that were dead, that were in prison, that were selling drugs… aides who were billing while jetsetting across the Caribbean and Europe.”
That is not a system with a few cracks. That is a system being looted.
The numbers bear it out. One home health aide allegedly submitted more than 1,100 claims for over 24 hours of work in a single day, totaling more than 64,000 hours and resulting in more than $1.2 million in Medicaid payments, the Washington Examiner reported. Other defendants allegedly billed for care while working ride-share or food delivery jobs on the side.
Assistant Attorney General Colin M. McDonald made clear the DOJ views these cases as deliberate theft, not clerical confusion.
“They are not paperwork errors or good-faith accounting errors.”
McDonald also framed the fraud in terms of who actually gets hurt, the elderly and vulnerable Americans the home care funding is supposed to serve. He stated, as reported by the Examiner, that “home care funding exists to assist America’s elderly and most vulnerable, not to fund schemes in which aides claim to be providing care while incarcerated or vacationing in Miami and Saudi Arabia.”
CMS Administrator Dr. Mehmet Oz echoed that concern. “Medicaid fraud robs hardworking taxpayers, deprives vulnerable Americans of the care they need, and undermines the public trust that sustains our social safety net,” Oz said.
The federal government has been ramping up health care fraud enforcement on multiple fronts. Earlier this year, the Trump administration moved to purge billions in alleged Obamacare fraud and removed millions from enrollment rolls, a sign that the appetite for rooting out waste in federal health programs extends well beyond a single city or strike force.
The Philadelphia expansion adds to a list of cities where the DOJ has planted strike force offices. Prior expansions brought the program to California, Arizona, Nevada, Massachusetts, and Minnesota.
The DOJ release stated that the expansion “brings enhanced federal resources to a district with an established tradition of strong health care fraud enforcement.” It added that the partnership “will uniquely enable law enforcement to combat criminals who hide behind corporations to commit fraud.”
The New York Post reported the broader crackdown has uncovered more than $21 billion in alleged losses across national enforcement actions in 2025 and 2026. One enforcement action in 2025 involved more than $15 billion in alleged losses. A second in 2026 involved more than $6 billion.
Those numbers dwarf the $4 million at issue in the Philadelphia cases. But the Philadelphia schemes illustrate how fraud operates at the street level, individual aides and company owners gaming a system that trusts its participants to report honestly.
The pattern is familiar. Federal investigators have exposed fake nursing diplomas in South Florida, where one woman admitted to selling nearly 3,000 fraudulent credentials. The common thread is a health care system so large and loosely policed that bad actors treat it as an open vault.
Alongside the new federal charges, Pennsylvania Attorney General Dave Sunday announced a plea agreement involving the final defendant in a previously charged 21-defendant case tied to more than $1.7 million in fraudulent claims. The identity of that defendant and the terms of the plea were not disclosed in the DOJ’s announcement.
Sunday’s involvement signals state-level cooperation with the federal strike force, a joint approach that prosecutors appear to be betting will produce faster results than either level of government working alone.
The DOJ said the strike force “will use every available legal tool to identify, investigate, and prosecute offenses against the American people.” That language is broad, and deliberately so. Federal prosecutors have grown increasingly aggressive in describing health care fraud not just as financial crime but as a direct attack on vulnerable populations and taxpayer resources.
That posture mirrors what federal prosecutors have said in other jurisdictions. In California, a federal prosecutor labeled the state a “fraudster’s paradise” and warned that state officials themselves could face charges for enabling fraud.
The DOJ release did not name the 19 individual defendants. It did not identify the home health care agency charged with false clock-ins and clock-outs. It did not specify which statutes the defendants were charged under, nor did it provide case or docket numbers.
The identity of the Medicaid recipient who allegedly worked as a carpenter while claiming extensive home health needs also went unnamed. So did the specific courts handling the cases.
These gaps matter. Transparency in federal fraud prosecutions depends on the public knowing who was charged, with what, and in which court. A press release announcing 19 defendants and $4 million in alleged fraud is a start. The dockets will tell the full story.
Federal fraud enforcement also has a long history of chasing fugitives across borders after indictments are handed down. Whether all 19 defendants in this case are in custody remains unclear.
Four million dollars is a rounding error in a federal health care system that spends hundreds of billions annually. But every dollar stolen from Medicare and Medicaid is a dollar that didn’t reach a homebound senior who actually needed help getting out of bed, taking medication, or eating a meal.
The defendants in this case allegedly billed for care they never provided, to patients who were in jail, in the hospital, or on the other side of the world. One aide claimed to work more than 24 hours a day, more than a thousand times. The system paid out anyway.
That is the real indictment, not just of the 19 people charged, but of a federal benefits apparatus so sprawling and so poorly monitored that a dead aide’s billing can go through without a flag.
Prosecutors can charge the fraudsters. But until the system that paid them without blinking gets the same scrutiny, the next 19 defendants are already clocking in.
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