Federal and state prosecutors have charged 19 people in recent days of defrauding Medicaid by submitting more than $4 million in phony billings through a program designed to compensate home health aides.
Top Trump administration officials gathered Tuesday morning at the federal building in Old City to detail the criminal cases and announce the expansion of a health care fraud strike force to Philadelphia.
“To those taking advantage of home health funds that are so critical to allowing aging and ill Americans to live and receive care at home, your time is up,” Assistant Attorney General Colin McDonald said. “The era of getting rich off the backs of our programs for our sick, elderly, and disabled is over.”
Pennsylvania distributes federal dollars to personal care assistants through an initiative aimed at keeping those with disabilities and the elderly out of nursing and long-term care homes. Often, the aide is a relative or friend of the client.
David Metcalf, the U.S. Attorney for the Eastern District of Pennsylvania, said there are few safeguards to ensure that the assistant is actually providing the services that are being billed to Medicaid.
“The beneficiary or the client can select whoever they wish to be their aide, and so therefore two people can easily collude to scheme this system,” he added.
Aides are supposed to clock in and out from the beneficiary’s home; however, the system can be easily falsified, with the client logging onto a cellphone application to log the assistant’s work hours, officials said. The pair then can split the reimbursement funds.
Authorities contend that costs for the program have skyrocketed in recent years, and they say fraudsters are robbing individuals who actually need home health care.
“Medicaid fraud is deeply impactful conduct,” Pennsylvania Attorney General Dave Sunday remarked. “This is not about someone merely working the system.”
As part of the bust, Sunday’s office charged Ashley Griffin, 27, with Medicaid fraud, theft by deception and conspiracy for allegedly billing the program $1.2 million over a period of about three-and-a-half years.
Griffin was employed by 13 different home health agencies in Philadelphia and the surrounding counties and reported working more than 24 hours in a single day on more than 1,000 occasions, prosecutors said. One day, she billed 126 hours, according to the AG’s Office.
In another case, federal authorities arrested four members of a Philadelphia family who allegedly made more than $400,000 from the program between 2021 and 2026.
Alyssa Cuculino, 27, was ‘on the clock’ as a home caregiver even as she worked for a vendor at the South Philadelphia Sports Complex; her co-defendant, 46-year-old Louise Israel, continued logging time as an assistant when she was behind bars, the U.S. Attorney’s Office said.
She was not the only one accused of continuing their home health career while incarcerated. When the Drug Enforcement Administration raided Khaleelah Williams’ home and arrested her husband, he told them he needed to punch out, prosecutors said.
After agents asked about his fake personal care assistance job, he replied, according to the U.S. Attorney’s Office: “Everybody is doing this. If this is a problem, you’ll have to arrest the whole city.”
Williams, 49, and Saleemah Davis, 29, ran Benevolent Home Health LLC, which continued to bill for Williams’ husband as he sat inside a federal jail on drug charges, prosecutors added. The agency also registered hundreds of shifts for an aide that died of cancer, the indictment against them asserts.
Another alleged drug dealer and home health assistant, 58-year-old Sean Murray, billed Medicaid for $400,000 over a seven-year period, during which he provided at least one client with cocaine as a kickback, according to the charging documents.
In an August 2024 phone call from jail, Murray told an associate that home health care “is the best kept secret,” authorities said. He logged shifts from aboard a cruise line and while on vacation in Florida, prosecutors stated.
“In fact, across the board, you look at fraud in healthcare — all gone up in the last six years,” said Dr. Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services, said at Tuesday’s news conference. “COVID appears to have unleashed massive fraud through grifters because criminals knew the federal government would not follow up on the money.”
White House officials argued that fraudsters flourished during President Joe Biden’s term, and President Donald Trump formed a fraud task force earlier this year headed up by Vice President JD Vance.
Federal officials said the Philadelphia-based busts build on investigations into schemes involving childhood autism services in Minnesota and hospices in California.
Two weeks ago, the Trump administration paused $1 billion in Medicaid funding to those states, based on allegations of fraud. The Democratic governors of California and Minnesota have characterized the decision as politically motivated.
MORE: Group stole more than $1M from Philly seniors, DA says
