HARRISBURG, PA — Pennsylvania’s Attorney General Dave Sunday announced that the state’s Medicaid Fraud Control Section has achieved the top national ranking in the number of fraud charges filed and third overall in convictions secured, according to an annual report from the U.S. Department of Health and Human Services Office of Inspector General.
The unit, housed within the Office of the Attorney General, investigates and prosecutes fraud targeting Medicaid, a critical program supporting limited-income and vulnerable populations. It also focuses on cases of neglect, abuse, or financial exploitation involving care-dependent individuals and older adults.
During the 2024 federal fiscal year, Pennsylvania’s Medicaid Fraud Control Section recovered over $11.3 million in misused Medicaid funds, primarily through criminal prosecutions. The section filed fraud charges against 113 individuals, brought neglect and abuse charges against six others, and secured 74 convictions, including cases carried over from previous years.
“Those who defraud our Medicaid program take vital services away from those in need while violating taxpayers who help fund the program,” Attorney General Sunday stated. “These are not victimless crimes, as people in urgent need of care suffer the most from these fraudulent acts.”
The report highlighted that Medicaid Fraud Control Units across the country recover $3.46 for every dollar spent. Pennsylvania’s leading position reflects its robust commitment to safeguarding public funds and prosecuting offenders.
Recent Southeastern Pennsylvania Cases
The announcement also detailed cases from southeastern Pennsylvania as examples of the office’s ongoing efforts.
- Dana Mason, 63, of Philadelphia County, faces fraud charges for billing Medicaid over $33,000 for services allegedly provided to a deceased person.
- Lewis Warner, 24, of Delaware County, received a sentence of six to 23 months in prison and probation after submitting 400 fraudulent claims for hours of personal care while the patient was hospitalized. He was ordered to repay $9,232.
- Shavon Parker, 39, a Licensed Practical Nurse from Philadelphia County, pleaded guilty after investigators found she billed for nearly 2,000 hours of nursing services she couldn’t have provided. She was ordered to pay over $96,000 in restitution.
- Polly Young, 60, of Delaware County, pleaded guilty to Medicaid Fraud for billing over 500 hours of personal care services while working at another job, resulting in probation and $10,271 in restitution.
- Tyesha Willis, 48, of Philadelphia County, also pleaded guilty for reporting hours of care while working as a school bus driver. She will serve probation and repay $5,636.
Attorney General Sunday reiterated his commitment to holding offenders accountable, ensuring those in need can access vital care without fraud undermining the integrity of the Medicaid program. The cases signal Pennsylvania’s effective collaboration between agencies in combating waste, fraud, and abuse.
“Residents of Pennsylvania deserve reassurance that this critical program will be protected against those who seek to exploit it,” Sunday affirmed.
Criminal charges are allegations, and all defendants are presumed innocent unless proven guilty.
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