Homecare costs of $4M paid to recipients on vacation, in jail or at work

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(The Center Square) – Taxpayers have covered millions of dollars in fraudulent homecare charges to Medicaid and Medicare since pandemic-era grants flooded the industry without proper oversight, federal investigators said Tuesday.

That money was paid to beneficiaries who were on international vacations, behind bars or working for ride share and food delivery apps. In other instances, homecare workers repeatedly billed government insurance for 400 shifts exceeding 24 hours per day.

The findings came from the Northeast Healthcare Fraud Strike Force, which said on Tuesday it has expanded into Philadelphia, where it will charge 19 defendants for scamming the Medicaid and Medicare system to the tune of $4 million.

“We will no longer tolerate fraud against our most vulnerable citizens and our most important health programs, and to anyone engaged in healthcare fraud of any kind, of any size, we see you, and we are doing everything we can to bring you to justice,” said Colin McDonald, assistant attorney general for the National Fraud Enforcement Division at the Department of Justice. “The era of getting rich off the backs of our programs for our sick, elderly, and disabled is over.”

Scammers often game the system by reporting together as caregivers and patients to claim payments for care that was never given or received. Dr. Mehmet Oz, administer of the U.S. Center for Medicaid and Medicare Services, said Pennsylvania ranks fifth nationally in average monthly payments to both beneficiaries and providers, totaling an average $50,000 per person.

Worse, he said, 96% of personal care claims are for unspecified illnesses, making them harder to track. He blames funds paid during the COVID-19 pandemic as the catalyst for “this corruption to be weaponized.”

“We have no tolerance for anyone who invents hours, invents a disability, invents a workforce at the expense of people who depend on these programs,” he said. “And if you love these most vulnerable Americans, you should care as well.”

The task force said Tuesday’s charges are an extension of the work done in California, Massachusetts and Minnesota.