The United States Department of Justice (DOJ) has announced a major expansion of its Health Care Fraud Strike Force to Philadelphia as part of an intensified crackdown on alleged fraud involving federally funded healthcare programmes. Simultaneously, federal and Pennsylvania authorities have charged 19 defendants for allegedly submitting fraudulent Medicare and Medicaid claims worth more than ₹34 crore (approximately US$4 million). The accused include owners and employees of home healthcare companies, purported home health aides, and Medicaid beneficiaries. Authorities said the enforcement action forms part of a broader strategy to combat organised financial crimes targeting public healthcare funds.
According to the DOJ, the newly established Strike Force office in the Eastern District of Pennsylvania will bring together the Department’s National Fraud Enforcement Division and the US Attorney’s Office to strengthen investigations and prosecutions involving healthcare fraud. Officials said the initiative is designed to enhance the government’s ability to dismantle criminal networks that exploit corporate structures to defraud taxpayer-funded healthcare programmes.
Investigators have alleged that several home health aides submitted Medicaid reimbursement claims for periods during which they were incarcerated, hospitalised, employed elsewhere, or travelling outside the United States. Despite being unavailable to provide care, they allegedly billed the government for home healthcare services that were never rendered.
In another case, prosecutors alleged that a Medicaid beneficiary claimed to require extensive home healthcare assistance while simultaneously working as a carpenter. Investigators believe the case reflects significant discrepancies between the individual’s declared medical needs and actual employment activities.
Authorities further alleged that some defendants submitted overlapping work schedules and impossible service claims, including billing for more than 24 hours of patient care within a single day. One home healthcare agency and its owners have also been accused of creating false employee clock-in and clock-out records to obtain fraudulent Medicaid reimbursements.
The DOJ said the Philadelphia Strike Force will operate in close coordination with the Department of Health and Human Services Office of Inspector General (HHS-OIG), the Federal Bureau of Investigation (FBI), the Drug Enforcement Administration (DEA), and other federal and state law enforcement agencies. Officials emphasised that every available legal tool would be used to detect, investigate, and prosecute healthcare fraud schemes that misuse public funds.
Pennsylvania authorities also announced a plea agreement involving the final defendant in a previously prosecuted healthcare fraud case involving 21 individuals. That investigation centred on fraudulent Medicare and Medicaid claims exceeding approximately ₹14.5 crore (around US$1.7 million).
The DOJ noted that the Philadelphia expansion follows similar additions to the Health Care Fraud Strike Force programme in California, Arizona, Nevada, Massachusetts, and Minnesota. The department stated that nationwide healthcare fraud enforcement actions in 2025 involved alleged losses exceeding ₹1.28 lakh crore (approximately US$15 billion), while actions initiated in 2026 have already targeted schemes involving more than ₹51,000 crore (approximately US$6 billion) in alleged losses.
Officials said the continued expansion of specialised strike forces demonstrates the US government’s commitment to protecting public healthcare resources, safeguarding taxpayer money, and dismantling organised fraud networks operating within Medicare and Medicaid programmes. They added that coordinated enforcement operations will continue as authorities intensify efforts to detect fraudulent billing practices, strengthen oversight of healthcare providers, and hold all individuals involved in financial crimes against public health insurance systems accountable under the law.
