Feds: 19 people charged in Medicaid home health care schemes

PHILADELPHIA (KYW Newsradio) — Pennsylvania’s attorney general and federal officials announced fraud charges against 19 people in connection with home health care schemes that netted more than $4 million in Medicaid funding. The alleged crimes have led to the creation of a program aimed at health care fraud.

Federal and state prosecutors said the defendants were fraudulently charging millions to Medicaid as home health care aides.

“Medicaid fraud in this state is costing taxpayers for care that was never delivered, or even worse, harmful,” said Dr. Mehmet Oz, administrator of the U.S. Centers for Medicare and Medicaid Services.

The U.S. Attorney’s Office is creating a $300 million grant program for state and local prosecutors to aid the Department of Justice in targeting fraud cases.

“Pennsylvania ranks fifth nationally in average monthly payments, both per beneficiary and per provider. That is way out there, being No. 5 in both those categories. More expensive, that is, than 45 states,” Oz said.

Pennsylvania Attorney General Dave Sunday said the reach of these crimes extends far beyond the millions of dollars that were defrauded.

“These cases aren't just financial crimes. These are cases that directly impact the health and safety of people in our community, especially through the neglect cases where care should be given and people are being paid to provide care, and then the care is not given.”

Sunday pointed to the example of 27-year-old Ashley Griffin, one of two defendants charged at the state level.

“In all, we counted, compiled, and compared, and found that Ashley submitted more than 64,000 hours of work for services that she absolutely could not have possibly done. Those fraudulent entries led to Medicaid payments of more than $1.2 million.”

Last year in Pennsylvania, 115 defendants were convicted of Medicaid fraud or related crimes. Those convictions led to the recovery of about $41 million that was stolen from the state Medicaid program.