DOJ (Re-)Expands Northeast Health Care Fraud Strike Force to Philadelphia and Charges 19 Defendants in Medicaid Home Care Schemes

On August 4, 2026, DOJ’s National Fraud Enforcement Division (“Fraud Division”) announced a significant expansion of its Northeast Health Care Fraud Strike Force into Philadelphia. The expansion will reunite the Fraud Division’s Health Care Fraud Section with the U.S. Attorney’s Office for the Eastern District of Pennsylvania; in 2018, the same teams launched what was then known as the Philadelphia-Newark Regional Strike Force, before reducing its operations to Newark-only in more recent years. Nationally, since its inception in 2007, the Health Care Fraud Strike Force program has been responsible for prosecuting more than 6,200 defendants who collectively billed federal health care programs and private insurers more than $45 billion.

This week’s announcement of the Philadelphia expansion follows recent additions to the Strike Force program on the West Coast and in the Districts of Massachusetts and Minnesota. The new Philadelphia team, like the other strike forces, will coordinate with HHS-OIG, the FBI, DEA, and other federal, state, and local law enforcement partners. DOJ characterized the initiative as part of its emphasis on “full-spectrum accountability”—pursuing alleged misconduct by companies and their owners, as well as employees, home care aides, and Medicaid recipients. DOJ also highlighted the Eastern District of Pennsylvania’s history of criminal and civil health care enforcement and its role as a venue for qui tams supporting that enforcement.

In connection with the expansion, federal and state authorities announced criminal charges against 19 defendants in alleged schemes involving more than $4 million in Medicaid claims. The federal cases generally allege that home care aides, Medicaid recipients, agency owners, and a home care company submitted or caused the submission of claims for services that were not provided. The alleged conduct included billing for services while purported aides or recipients were incarcerated, hospitalized, traveling overseas, working other jobs, attending court proceedings, or otherwise unavailable. Authorities also alleged the use of false electronic visit verification (“EVV”) entries, overlapping shifts, payments shared with recipients, and identity theft as well as fraud charges for services attributed to aides who were seriously ill or deceased.

The announcement underscores that health care fraud remains a top DOJ enforcement priority and indicates that Department leadership expects U.S. Attorneys nationwide to pursue these matters, including alongside the new National Fraud Enforcement Division’s Health Care Fraud Section. That Section was previously the Fraud Section’s Health Care Fraud Unit, which may explain why the Criminal Division, Fraud Section Chief appeared with the U.S. Attorney for the Eastern District of Pennsylvania on several of the indictments featured in the announcement. Consistent with other recent enforcement efforts showcasing increased prioritization on work with state authorities, it is notable that these matters were Medicaid cases (and smaller-dollar). For companies and individuals operating in the home care industry, it also highlights DOJ’s scrutiny of allegedly false EVV entries and suggests that home care agencies should carefully evaluate their controls over EVV credentials and adjustments, as DOJ may be using data analytics—and cooperators from these recently-charged matters—to build more, similar cases to present for indictment in the future.

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