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PHILADELPHIA - A dozen people and a home care agency in Philadelphia face federal charges for allegedly conspiring to defraud the Pennsylvania Medicaid program, according to United States Attorney David Metcalf.
What we know:
Metcalf said the charges stem from multiple indictments accusing defendants of billing Medicaid for home care services that were never provided, including claims for caregivers who were dead, incarcerated, or working elsewhere.
"It is outrageous and unacceptable that anyone could steal money by billing nonexistent home care services for caregivers who were, in fact, dead, in prison, or trafficking drugs," said Metcalf.
The first set of indictments charges Joseph Pizzo and Tiziana Taormina with causing at least $160,000 in fraudulent Medicaid claims by submitting false time sheets, including while Pizzo was in jail or working construction.
Another indictment accuses Donna Romsteadt, Alyssa Cuculino, Louise Israel, and Elexis Cuculino of a similar scheme, allegedly resulting in about $445,000 in fraudulent payouts.
A third indictment charges Albert Coccia Jr. and Santino Coccia with billing Medicaid for care that was not provided, including times when Santino Coccia was working as a rideshare and food delivery driver, allegedly causing at least $211,000 in fraudulent claims.
The second federal case focuses on Sean Murray and Charles Bowie, both accused of billing Medicaid for home care services while traveling, at the gym, or selling drugs. Murray allegedly submitted $400,000 in fraudulent claims, while Bowie is accused of about $600,000 in fake billings.
A separate case charges Khaleelah Williams and Saleemah Davis, owners of Benevolent Home Health LLC, with billing Medicaid for care provided by a deceased aide and by Williams’ husband while he was allegedly trafficking drugs or in federal custody. Prosecutors say their scheme resulted in about $224,000 in fraudulent claims.
What they're saying:
Attorney General Dave Sunday said his office has been working with federal partners to crack down on Medicaid fraud.
"This criminal conduct is much more than someone ‘working the system’ — the impact is deep and wide-ranging, as every dollar diverted deprives someone in need of care," said Sunday. "In collaboration with our partners, my office last year convicted more than 100 defendants, and clawed back more than $40 million that was intended for Pennsylvanians in need."
Prosecutors say the schemes involved family members, fake time sheets, and kickbacks to clients. The cases highlight ongoing efforts to protect Medicaid funds and hold offenders accountable.
Big picture view:
The indictments represent a coordinated effort by federal and state officials to address large-scale health care fraud in Pennsylvania. The alleged schemes targeted Medicaid, a program designed to help those in need, and involved millions of dollars in fraudulent claims.
Authorities say these cases are part of a broader crackdown on health care fraud, with ongoing investigations and prosecutions expected.