Independent guide and data. Not a government website. Reporting fraud to the government is always free.

Pennsylvania Medicaid fraud cases

Every Justice Department announcement of Medicaid fraud prosecuted in Pennsylvania since January 20, 2025.

All announcements

DateAnnouncementStageAmount
2026-06-23Scranton Woman Charged With Conspiracy To Commit Bank Fraud With Funds Derived From Federal Health Care ProgramsCharged$300K
2026-06-10Ahold Delhaize USA Inc. to Pay $40M for Allegedly Reporting Inflated Drug Prices on Claims to Federal Healthcare ProgramsCivil settlement$40M
2026-04-30PA Lifesharing, LCC Agrees To Pay $1.2M To Settle False Claims Act AllegationsCivil settlement$1.2M
2026-03-11Aetna Agrees to Pay $117.7 Million to Resolve False Claims Act AllegationsCivil settlement$117.7M
2026-03-09Pennsylvania Brothers Convicted of Decades Long Racketeering ConspiracyConvicted at trial$32M
2025-11-17Aesculap Implant Systems Agrees to Pay $38.5 Million to Resolve False Claims Act Allegations Related to Knee Implant FailuresCivil settlement$38.5M
2025-10-16Bucks County Home Care Company and Its Owners and Managers Charged in Alleged Health Care Fraud SchemeCharged—
2025-09-08Owner of Facility for Intellectually Disabled Adults Pleads Guilty to Health Care FraudPleaded guilty—
2025-08-20Philadelphia Man Sentenced to Over Two Years in Prison for Defrauding the Government of More Than $1 Million in SNAP, Medicaid BenefitsSentenced$399K
2025-08-12Superseding Indictment Against Pittsburgh Health Care Facility Owner Adds Charges of Social Security Fraud and Concealing Material Facts Related to Health Care MattersCharged—
2025-05-20Pittsburgh-Area Nursing Home Companies Ordered to Pay More Than $15 Million in Restitution for Health Care FraudSentenced$15M
2025-05-20Business Owner Pleads Guilty to Fraud and Money Laundering SchemesPleaded guilty—
2025-03-03Harrisburg Woman Sentenced To 41 Months in Prison for Health Care Fraud And Bank Fraud ChargesSentenced$3.3M
2025-01-27Philadelphia Mental Health Clinic and Its Psychiatrist Owner Agree to Pay $900,000 to Resolve False Claims Act Lawsuit for Alleged Medicaid FraudCivil settlement$900K

Source: U.S. Department of Justice press releases. Amounts should not be added: one case can appear at several stages. Charged cases are allegations.

Where to report Medicaid fraud in Pennsylvania

Medicaid fraud is covered by the federal WHIP program: a tip that leads to criminal charges can earn $10,000–$30,000. More on reporting Medicaid fraud, all fraud cases and reward laws in Pennsylvania, and Medicaid cases in every state.

Frequently asked questions

How many Medicaid fraud cases has the DOJ announced in Pennsylvania?

14 announcements since January 20, 2025, or 4.6% of all Medicaid announcements in our database. Each press release is counted separately, so one case can appear at charge, plea and sentencing.

How do I report Medicaid fraud in Pennsylvania?

Medicaid Fraud Control Section (MFCS) (717-712-1220); HHS Office of Inspector General (1-800-HHS-TIPS (1-800-447-8477)); America.gov/fraud (WHIP reward portal). To be eligible for a federal WHIP award, submit the tip in writing at America.gov/fraud.

Sources

  1. U.S. Department of Justice press releases (justice.gov/news)
  2. HHS-OIG: Report fraud
  3. HHS-OIG: Medicaid Fraud Control Units
  4. DOJ: National Fraud Enforcement Division Criminal Tip Rewards Pilot Program, terms and conditions (updated Oct. 20, 2026)