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DOJ announces charges in Pennsylvania home‑health Medicaid fraud cases; 19 defendants indicted
Summary
Federal and state prosecutors announced indictments charging 19 defendants in coordinated enforcement actions alleging more than $4 million in home‑health Medicaid fraud in Pennsylvania; officials said the cases include schemes that billed for services not provided, billed while providers were incarcerated, and used fabricated clock‑ins.
Federal and state law enforcement officials in Philadelphia on Thursday announced criminal charges against 19 defendants in a coordinated sweep that prosecutors say targeted fraudulent home‑health billing in Pennsylvania.
"Everywhere we look, we find fraud," Colin McDonald, assistant attorney general for the National Fraud Enforcement Division, said as he opened the press event. McDonald said 18 of the defendants were charged in the previous 12 days and that the cases collectively involve more than $4,000,000 in alleged false Medicaid billings.
U.S. Attorney David Metcalfe said investigators uncovered schemes in which caregivers or agencies billed Medicaid for services that were never provided. He described examples prosecutors allege: a defendant who billed while incarcerated, providers who submitted fabricated clock‑ins and a company that billed for an aide who was dead. "We allege $400,000 in total billings" in one scheme, Metcalfe said of an example involving alleged kickbacks to beneficiaries.
Metcalfe warned that the alleged conduct ranges from individual fraud to organized, sophisticated schemes. He named cases brought by the office, including charges involving Sean Murray and a home‑health company, Benevolent Home Health, whose founders are identified in indictments as Khalil Williams and Salima Davis. Prosecutors said some allegations grew out of parallel drug‑trafficking investigations and identified social media and surveillance evidence used to track billing while alleged perpetrators traveled.
All officials repeatedly noted that the allegations are not proof of guilt and that each defendant is presumed innocent until proven guilty in court. The announcement follows coordination between the Department of Justice's Fraud Division, the U.S. Attorney's Office for the Eastern District of Pennsylvania and the Pennsylvania Attorney General's Office.
The event highlighted investigative techniques that combined data analytics, audits and traditional fieldwork. Prosecutors said the cases are part of an expanded national effort to use federal resources, strike forces and interagency cooperation to identify and prosecute Medicaid fraud.
