PHILADELPHIA — Federal and Pennsylvania authorities charged 19 defendants Tuesday, Aug. 4, in alleged health care fraud schemes involving more than $4 million in Medicare and Medicaid claims.
The Justice Department also expanded its Northeast Health Care Fraud Strike Force into Philadelphia. The move adds specialized prosecutors, investigators and claims analysts to the Eastern District of Pennsylvania.
The defendants include home health company owners, employees, purported caregivers and Medicaid recipients. The Philadelphia fraud announcement Tuesday marked the latest federal effort to identify false claims involving taxpayer-funded medical programs.
Pennsylvania Attorney General Dave Sunday separately announced charges against two personal care attendants. Authorities accuse Ashley Griffin, 27, and Yolanda Wright, 49, of seeking nearly $1.5 million for work that was not performed.
All charges remain allegations. Each defendant is presumed innocent unless convicted or found guilty through the court process.
Strike force expands into Philadelphia.
The Philadelphia office will combine resources from the Justice Department’s National Fraud Enforcement Division and the U.S. Attorney’s Office for the Eastern District of Pennsylvania.
Investigators from the FBI, Drug Enforcement Administration and Department of Health and Human Services Office of Inspector General will support the operation. Other federal and state agencies may also assist individual cases.
Health care fraud strike forces bring prosecutors and investigators into teams focused on suspicious billing. They also use claims analysis to find impossible schedules, duplicate services and sudden changes in provider activity.
Federal officials said the expansion would help authorities pursue people who allegedly use companies to disguise fraudulent conduct. The regional strike force teams combine data analytics with federal, state and local investigative resources.
The government has used similar teams in several regions. Recent expansions have included operations in California, Arizona, Nevada, Massachusetts and Minnesota.
Claims involved unavailable caregivers
Several Philadelphia-area cases involve home health services allegedly billed when caregivers could not have provided them. Authorities said some aides claimed Medicaid-funded hours while they were incarcerated or hospitalized. Others allegedly submitted claims while working different jobs or traveling outside the United States.
Investigators also identified overlapping schedules and daily totals that exceeded 24 hours. Such entries can indicate that one worker claimed to serve multiple recipients at the same time.
One Medicaid recipient allegedly claimed to need extensive home assistance while working as a carpenter. Prosecutors have not established that employment alone proves the recipient was ineligible for care.
A separate home health agency and its owners face allegations involving false electronic clock-ins and clock-outs. Authorities claim the records made unprovided services appear eligible for reimbursement.
The claims exceeded four million, but that amount does not necessarily represent the government’s final loss. It reflects claims connected to the alleged schemes described during the enforcement announcement.
Two attendants charged separately.
Sunday’s office accused Griffin and Wright of felony Medicaid fraud, theft by deception and conspiracy.
Investigators allege Griffin submitted more than 64,000 work hours between 2020 and 2023. Those entries generated about $1.2 million in Medicaid reimbursements for services authorities say she did not provide.
Griffin allegedly reported more than 24 hours of work on over 1,000 days. One entry listed 126 hours within a single day. She worked as a personal care attendant through agencies operating in Philadelphia, Montgomery, Delaware and Bucks counties.
Authorities questioned Griffin about the billing in September 2025. Entries submitted under her name then dropped sharply, investigators said. The state alleges Griffin paid Wright to continue entering false hours under Wright’s identity. Those later submissions generated more than $275,000 in reimbursements.
The pair submitted impossible hours, including shifts that could not fit within a normal calendar day. Senior Deputy Attorney General Susann Shore will prosecute the cases. Neither woman has been convicted. The attorney general’s office said the criminal allegations must be resolved in court.
Earlier agency case produced pleas.
Tuesday’s announcement also included an update involving ComfortZone Home Health Care, an East Norriton-based Medicaid provider. State authorities charged 20 people and the company following an investigation into $1.76 million in allegedly false claims. The disputed claims involved personal assistance services billed between 2020 and 2023.
Former chief executive Naya Campbell pleaded guilty to corrupt organizations, theft by deception and Medicaid fraud. A Montgomery County judge sentenced her in March to 11½ to 23 months in prison.
The court also imposed five years of probation, 100 hours of community service and restitution obligations. Campbell had supervised the company’s daily operations. Her mother, company owner Stephanie Mobley, also pleaded guilty. Former office manager Barbara Thomas received a sentence of nine to 23 months in prison.
The attorney general’s office said 19 defendants connected to the agency had entered guilty pleas by March. Several had been sentenced, while other proceedings remained pending. The completed pleas differ from the newly filed Philadelphia charges. Those defendants retain the presumption of innocence as their individual cases proceed.
National operation charged hundreds.
The Philadelphia action follows a nationwide health care fraud crackdown announced June 23. Federal prosecutors charged 455 defendants, including 90 doctors and other licensed medical professionals. The alleged schemes involved more than $6.5 billion in false claims.
The national operation charged defendants across 56 federal districts and 45 states and territories. Every state Medicaid Fraud Control Unit participated. The Justice Department said 295 defendants faced Medicaid-related allegations involving more than $518 million in false claims.
Federal health officials also suspended 1,079 providers and revoked billing privileges for 1,403 providers. Authorities seized more than $182 million in cash and assets connected to the wider operation. Claims analysts helped identify providers who allegedly billed hundreds of service hours in a single day. Investigators also examined unusual increases in billing and conflicting service records.
Defendants await separate proceedings.
The 19 defendants announced Tuesday will not necessarily appear in one case or before one judge. Each prosecution will follow its own charges, evidence and court schedule.
Federal and state prosecutors must prove that each defendant knowingly participated in fraud. Billing mistakes, inaccurate time entries or administrative problems do not automatically establish criminal intent.
Authorities had not announced one court date covering all defendants by Tuesday evening. The new Philadelphia strike force will continue reviewing regional Medicare and Medicaid claims while the filed cases move through federal and state courts.
