Source: United States Department of Justice Criminal Division
Division Expands Northeast Strike Force to Philadelphia to Target Health Care Fraud Schemes, Provide Full-Spectrum Accountability
The Justice Department’s National Fraud Enforcement Division (Fraud Division) announced a major investment in combatting Medicaid fraud through a significant expansion of the Division’s Northeast Health Care Fraud Strike Force to Philadelphia, Pennsylvania, an enforcement initiative uniting the Division’s Health Care Fraud Section with the U.S. Attorney’s Office for the Eastern District of Pennsylvania. The Health Care Strike Force model has proven to be one of the most powerful tools in the federal enforcement arsenal, responsible nationally for the prosecution of over 6,200 defendants who collectively billed federal health care programs and private insurers more than $45 billion.
In connection with the announcement, the Fraud Division, U.S. Attorney’s Office, and Pennsylvania Attorney General today announced criminal charges against 19 defendants, including owners and employees of home care companies, for their alleged participation in various fraud schemes involving over four million dollars in claims to Medicare and Medicaid. The Pennsylvania Attorney General also announced a plea agreement involving the final defendant in a previously-charged 21 defendant case involving over $1.7 million in claims.
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 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. Philadelphia and its surrounding areas have vibrant and cutting-edge health care technology and insurance industries, and the Eastern District of Pennsylvania has long been a prime venue for private lawsuits that bring unlawful corporate conduct in the health care industry to the attention of law enforcement. The Unit’s corporate enforcement efforts align closely with the U.S. Attorney’s Office in the Eastern District of Pennsylvania and its history of successful criminal and civil actions against corporate bad actors operating in the health care industry. In particular, the Health Care Fraud Unit has significantly expanded its focus on corporate accountability, resolving cases against companies engaged in systemic illegal conduct, including recent corporate resolutions with AP of South Florida LLC, Atlantic Biologicals Corp., ExThera, and Troy Health Inc. Just last week, the Fraud Division announced the first declination of a health care company under the new Department-wide Corporate Enforcement Policy, which resulted from a voluntary self-disclosure by eye care group Campus Eye.
“Home care funding exists to assist America’s elderly and most vulnerable — not to fund schemes in which aides claim be providing care while incarcerated or vacationing in Miami and Saudi Arabia,” said Assistant Attorney General Colin M. McDonald of the Justice Department’s National Fraud Enforcement Division. “Today’s charges and the expansion of our Northeast Strike Force into the Eastern District of Pennsylvania send a clear message to fraudsters in the region: the Department of Justice will relentlessly pursue you and use all available tools to protect Medicaid and the programs everyday Americans rely on.”
“Medicaid fraud robs hardworking taxpayers, deprives vulnerable Americans of the care they need, and undermines the public trust that sustains our social safety net,” said CMS Administrator Dr. Mehmet Oz. “CMS will continue partnering with law enforcement to shut down these scams while establishing new anti-fraud safeguards that flag criminal activity before the money ever leaves the building. This Administration is taking a whole-of-government approach to protecting Medicaid—ensuring the program serves the Americans who depend on it, not criminals seeking to exploit it.”
“Home care fraud is everywhere, and the victim is all of us taxpayers. Medicaid claims data and the experience of veteran prosecutors all point to the systematic exploitation of reimbursable home care programs,” said U.S. Attorney David Metcalf for the Eastern District of Pennsylvania. “Today, we sound the alarm on the scale of this fraud by announcing some truly egregious cases, in which numerous people are charged with filing fraudulent claims for caregivers who were not actually providing home care services, but in fact were dead, in prison, or trafficking drugs. This racket ends today.”
“Health care fraud is not a victimless crime – it undermines public trust and diverts critical resources from patients who need them,” said Special Agent in Charge Wayne A. Jacobs of the FBI Philadelphia Field Office. “No single agency can tackle complex health care fraud schemes alone. Let today’s announcement be a warning to those engaging in similar activity: if you seek to exploit our health care systems for personal profit, you should expect the FBI and our partners to uncover your scheme and bring it to an end. Every dollar stolen through fraud is a dollar diverted from patient care, and the FBI will continue its work to safeguard the public’s trust and hold accountable those who abuse these vital programs.”
Today’s announcement, which charges company owners, home health aides, and Medicaid recipients, including individuals with significant criminal records, shows the diversity of the Fraud Division’s work and its emphasis on full-spectrum accountability. 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 Fraud Division and its partners in the Eastern District of Pennsylvania and the Pennsylvania Office of the Attorney General will pursue anybody who seeks to profit at the expense of American taxpayers, regardless of whether the wrongdoing is in the boardroom or in the sickroom. With the newly expanded Northeast Strike Force, the District will have the resources to pursue these allegations and ensure that corporate criminal actors are brought to justice.
Home Care Fraud
Recently, the Eastern District of Pennsylvania has become the target of fraudsters seeking to take advantage of Medicaid’s home care funds, which should be devoted to assisting elderly and ill Pennsylvanians to age in place with dignity. Today’s announcement is a result of coordinated and dedicated investigations and prosecutions at the federal and state levels.
Today’s cases demonstrate that even the boldest fraudsters will be caught and stopped. In one case announced today Cuculino, four defendants, two purported aides and two Medicaid recipients, were charged in connection with a conspiracy to submit claims for home health services that never occurred. One purported aide claimed to be providing services while she was incarcerated; another purportedly provided services while hospitalized. These four defendants caused over $440,000 in claims to Medicaid. In another of today’s cases Coccia, two defendants, father and son, were charged after the son, a purported aide, claimed to be providing services while driving for a ride-share and food delivery service. On one occasion, the defendants claimed services while the son was in the midst of a traffic stop in which he was cited for possession of marijuana; on another, the defendants claimed services while the father was in court participating in a sentencing hearing for another individual. Medicaid paid over $200,000 for care purportedly provided to the father. In a third case being announced today Pizzo, a purported aide and a Medicaid recipient were charged after the recipient claimed to be so debilitated that he needed dozens of hours of home health assistance, resulting in over $160,000 in claims to Medicaid. In reality, the recipient had a day job as a carpenter working in the construction industry.
Social media posts depicting defendant’s vacation to Miami, Florida, while he billed for providing home care services to a Medicaid recipient in the Eastern District of Pennsylvania.
The defendants’ conduct was characterized by extraordinary greed. In one case, the Pennsylvania Attorney General charged a purported home health aide Griffin who claimed to have provided services to up to seven Medicaid recipients at once. On over 1,100 occasions, the defendant allegedly claimed to have provided care for more than 24 hours in a single day, totaling over 64,000 hours that could not have been worked. As alleged, Medicaid paid over $1.2 million as a result of the scheme. Another defendant Johnson who was charged in today’s announcement, a purported aide, claimed to have worked over 8,700 overlapping hours. As alleged, there were nearly 400 days on which the defendant claimed to be working for more than 24 hours in a day. The defendant allegedly caused over $180,000 in loss to Medicaid. In another case, a defendant Grier was charged who claimed to have provided over 1,300 hours of home care services for a Medicaid recipient who was himself incarcerated on state drug charges. A defendant in one case Murray was captured on a recorded conversation stating that “this home health care is the best kept secret . . . I made a buck plus [each of] the last five years, that’s, that’s a half a million dollars . . . I ain’t checking on nobody.”
The defendants in today’s announcement were not deterred by the physical impossibility of their claims, as several defendants were charged with claiming to have provided services while they were out of the country. For example, one defendant Montgomery pleaded guilty to charges brought by the Pennsylvania Attorney General for his claims to be providing home care services while he was, among other places, in Saudia Arabia. Nineteen other defendants previously pleaded guilty in connection with this case. Another defendant Bowie, charged by the U.S. Attorney’s Office for the Eastern District of Pennsylvania, allegedly claimed to provide services while traveling overseas on multiple occasions. The defendant caused nearly $600,000 in claims to Medicaid, most of which were fraudulent.
Today’s announcement also includes a home care agency Benevolent, which was charged alongside its two owners. As alleged, the agency and its owners billed Medicaid for hundreds of false and fraudulent clock-ins and clock-outs for home care shifts, falsely representing that two agency employees were providing home care services to clients. In total, the defendants caused Medicaid to pay approximately $224,000 for the affected employees’ purported work.
“Today’s announcement underscores the need to confront Medicaid and Medicare fraud head on,” said Department of Health and Human Services Inspector General T. March Bell. “The schemes alleged here involved fabricated services, impossible work hours, and claims made while defendants were incarcerated, overseas, or working other jobs. Together with our federal and state partners, we remain steadfast in protecting Medicaid and Medicare by pursuing anyone who seeks to exploit these programs and the people they are designed to serve.”
Expanding the Northeast Strike Force to the Eastern District of Pennsylvania
As part of the expansion, the Northeast Strike Force, led by Acting Assistant Chiefs Miriam Glaser Dauermann and Patrick J. Campbell, will coordinate closely with the Eastern District of Pennsylvania’s Health Care Fraud Section, led by Assistant U.S. Attorneys Tony Scicchitano and Paul Shapiro, to establish the new office of the Strike Force. The Strike Force will work in partnership with the HHS Office of Inspector General, the Federal Bureau of Investigation, the Drug Enforcement Administration, and other law enforcement partners, reflecting the Department’s determination that the need for coordinated, aggressive action in this region is urgent and undeniable.
“Health care fraud is not just a financial crime, it threatens public safety and victimizes the American people,” said DEA Philadelphia Special Agent in Charge Timothy Flaherty. “Our message is clear: if you are a medical provider who chooses greed over your professional responsibility, DEA will hold you accountable.”
The expansion of the Northeast Strike Force to Philadelphia builds on the recent expansion of the Strike Force program to the West Coast, including the Northern District of California and the Districts of Arizona and Nevada; the District of Massachusetts; and the District of Minnesota, and comes after two record-setting National Health Care Fraud Takedowns in which the Division charged more than $15 billion in alleged loss in 2025 and more than $6 billion in alleged loss in 2026. A third-party consulting group analyzed return on investment and showed that the average return on investment (FY21-24) from funding the Health Care Fraud Section by year 10 is $106.76 per $1 spent, and over $4.5 billion in projected savings. Members of the public are encouraged to report wrongdoing in the health care industry, and the new Department-wide corporate enforcement policy for criminal matters creates incentives for companies to voluntarily disclose when misconduct occurs.
Acting Assistant Chief Miriam Glaser Dauermann, Health Care Fraud Trial Attorneys Paul J. Koob and Carla Jordan-Detamore, and Eastern District of Pennsylvania Health Care Fraud Chief Anthony Scicchitano, Deputy Chief Paul Shapiro, and Counsel to the U.S. Attorney Sara Solow, led and coordinated the cases charged in today’s Takedown, together with the FBI, HHS, DEA, IRS, and state and local law enforcement partners. Trial Attorneys Paul J. Koob and Carla Jordan-Detamore, Assistant U.S. Attorneys Sara Solow, Paul Shapiro, Angella Middleton, Alisa Shver, Jessica Rice and Megan Curran, and Pennsylvania Deputy Attorneys General Benjamin McKenna, Susann Shore, Jonathan Clymer and Jacob Gordin are prosecuting the cases being announced today.
On April 7, the Department of Justice announced the creation of the Fraud Division. The Fraud Division is laser-focused on investigating and prosecuting those who commit fraud against the American people. The Department’s work to combat fraud supports President Trump’s Task Force to Eliminate Fraud, a whole-of-government effort chaired by Vice President J.D. Vance to eliminate fraud, waste, and abuse within Federal benefit programs.