Dozens Charged With Health Care Fraud in Federal and State Cases Involving $5.76 Million in Billings to Pennsylvania’s Medicaid Program

PHILADELPHIA - United States Attorney David Metcalf announced that 12 individuals and an agency have been charged by federal indictment and additional defendants charged by the Pennsylvania Office of Attorney General with health care fraud and other offenses, for allegedly conspiring to defraud the Pennsylvania Medicaid program.

U.S. Attorney Metcalf discussed the cases at a news conference this morning, alongside Assistant Attorney General Colin McDonald of the Department of Justice's National Fraud Enforcement Division; Pennsylvania Attorney General Dave Sunday; Scott Brady, Executive Director of the White House Task Force to Eliminate Fraud; Dr. Mehmet Oz, Administrator of the Centers for Medicare and Medicaid Services; T. March Bell, Department of Health and Human Services Inspector General; Wayne Jacobs, Special Agent in Charge of FBI Philadelphia; Stanley Rutkowski, Assistant Special Agent in Charge of Health and Human Services Office of Inspector General ("HHS-OIG"), Philadelphia Regional Office; Timothy Flaherty, Special Agent in Charge of DEA Philadelphia; and Larry Arrow, Assistant Special Agent in Charge of IRS Criminal Investigation ("IRS-CI") in Philadelphia.

"The great fraud against the American taxpayer takes many forms," said U.S. Attorney Metcalf. "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."

In addition, AAG McDonald announced a significant expansion of the Fraud Division's Northeast Health Care Fraud Strike Force to Philadelphia, an enforcement initiative uniting the Division's Health Care Fraud Section with the U.S. Attorney's Office for the Eastern District of Pennsylvania. The Health Care Strike Force model has proven to be one of the most powerful tools in the federal enforcement arsenal, responsible nationally for the prosecution of over 6,200 defendants who collectively billed federal health care programs and private insurers more than $45 billion.

The Strike Force's expansion into the Eastern District of Pennsylvania brings enhanced federal resources to a district with an established tradition of strong health care fraud enforcement. The partnership between the Fraud Division and the Eastern District of Pennsylvania will uniquely enable law enforcement to combat criminals who hide behind corporations to commit fraud. Philadelphia and its surrounding areas have vibrant and cutting-edge health care technology and insurance industries, and the Eastern District of Pennsylvania has long been a prime venue for private lawsuits that bring unlawful corporate conduct in the health care industry to the attention of law enforcement.

"Home care funding exists to assist America's elderly and most vulnerable - not to fund schemes in which aides claim be providing care while incarcerated or vacationing in Miami and Saudi Arabia," said Assistant Attorney General McDonald. "Today's charges and the expansion of our Northeast Strike Force into the Eastern District of Pennsylvania send a clear message to fraudsters in the region: the Department of Justice will relentlessly pursue you and use all available tools to protect Medicaid and the programs everyday Americans rely on."

"The magnitude of home care fraud is shocking and requires the total force of the United States government to solve," said U.S. Attorney Metcalf. "This is why we are excited to announce the return of the Philadelphia Fraud Strike Force, partner with the National Fraud Enforcement Division, and enhance our alliance with Pennsylvania Attorney General Dave Sunday."

The Unit's corporate enforcement efforts align closely with the U.S. Attorney's Office for the Eastern District of Pennsylvania and its history of successful criminal and civil actions against corporate bad actors operating in the health care industry.

Recently, the Eastern District of Pennsylvania has become the target of fraudsters seeking to take advantage of Medicaid's home health care funds, which should be devoted to assisting elderly and ill Pennsylvanians to age in place with dignity. Today's announcement is a result of coordinated and dedicated investigations and prosecutions at the federal and state levels.

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Three federal cases were the focus of today's takedown; the first case involves three separate indictments charging a total of eight defendants.

The first indictment charges Joseph Pizzo, 47, and Tiziana Taormina, 52, both of Philadelphia, with conspiracy to commit health care fraud, and multiple counts of health care fraud

The indictment alleges that, from about July 2023 to April 2024, and about July 2024 to May of this year, Taormina, a personal care aide with "Agency 1," and Pizzo, a Medicaid recipient, schemed to defraud Medicaid.

They did so through a series of false and fraudulent clock-ins, for care she purportedly provided to Pizzo - including while he was incarcerated in Bucks County, and while he was working a construction job. In total, the indictment alleges that Taormina and Pizzo's scheme caused a payout of at least $160,000 in Medicaid claims.

The second indictment in the case charges Donna Romsteadt, 63, Alyssa Cuculino, 27, Louise Israel, 46, and Elexis Cuculino, 51, all of Philadelphia, with a similar conspiracy and health care fraud offenses.

Alyssa Cuculino is the daughter of Elexis Cuculino and the niece of Donna Romsteadt. Alyssa Cuculino and Israel were the home care aides, employed by "Agency 1," and Romsteadt and Elexis Cuculino were the Medicaid recipients for whom the aides purportedly provided home care.

Also referenced in the indictment is Medicaid "Recipient #1," a relative of Romsteadt's who resided with her. Both Israel and Alyssa Cuculino purportedly provided, and billed for, services to "Recipient #1" for lengthy periods. Israel also sought payment for Romsteadt's supposed care, and Alyssa billed for care she supposedly provided her mother Elexis.

Again, the indictment alleges no-show billing, with Alyssa Cuculino working at another job, or even hospitalized, during times she claimed that she was providing home care. Israel was, at times, incarcerated while purportedly providing care services. As alleged, Romsteadt and Elexis Cuculino actively assisted in the conspiracy, performing fraudulent clock-ins for Alyssa Cuculino and Israel. In total, these four defendants allegedly caused approximately $445,000 in fraudulent claim payouts.

Finally, the third indictment in this case charges Albert Coccia Jr., 56, and Santino Coccia, 28, both of Philadelphia, with conspiracy to commit health care fraud and multiple counts of health care fraud. Albert Coccia Jr., a Medicaid recipient, is the father of Santino Coccia, a home care aide with "Agency 1."

The indictment alleges repeated billing for care Santino Coccia supposedly provided to his father, at times when Santino Coccia was actually behind the wheel, making hundreds of trips as a contractor for a national rideshare and food-delivery provider. The indictment alleges that the Coccias conspired to cause fraudulent claims and payouts totaling at least $211,000.

The case involving these indictments was investigated by the FBI and HHS-OIG and is being prosecuted jointly by Trial Attorneys Paul J. Koob and Carla Jordan-Detamore of DOJ's Health Care Fraud Strike Force and Assistant United States Attorney Paul Shapiro of the Eastern District of Pennsylvania.

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The second federal case features separate indictments against Sean Murray, 58, and Charles Bowie, 53, both of Philadelphia, who both worked for "Home Care Company 1."

Murray was indicted on one count of health care fraud and nine counts of wire fraud, arising from an alleged scheme to defraud Medicaid through fraudulent home care services. He is already awaiting trial in the Eastern District of Pennsylvania for separate narcotics trafficking and firearms charges.

The indictment alleges that most of what Murray billed for home care services occurred while he was actually at the gym, massage parlor, traveling, or even selling illegal drugs, with Murray paying kickbacks to clients to go along with the scheme. The indictment alleges $400,000 in billings by Murray, the vast majority of which were for services not rendered.

Bowie was indicted on one count of health care fraud and 13 counts of wire fraud, arising from a similar scheme. The indictment alleges that he billed for purported home care services rendered at times when, in reality, he was vacationing in Saudi Arabia, Jamaica, Colombia, and other destinations. As alleged, Bowie caused approximately $600,000 in Medicaid billings, the vast majority of which were fraudulent.

This case was investigated by the FBI, HHS-OIG, and IRS-CI and is being prosecuted by Assistant United States Attorneys Sara Solow and Angella Middleton.

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In the third federal case, Khaleelah Williams, 49, and Saleemah Davis, 29, both of Philadelphia, and the home care agency they own, Benevolent Home Health LLC, have been charged with health care fraud conspiracy, health care fraud, and 14 counts of wire fraud. In addition, Williams and Davis have each been charged with two counts of aggravated identity theft.

The indictment alleges that Williams billed Medicaid for home care services purportedly provided by her husband, both while he was allegedly trafficking narcotics and after he was detained in federal custody on drug trafficking charges. Davis and Williams also billed for home care services purportedly performed by aide who was deceased. As alleged, Williams and Davis made approximately $224,000 in fraudulent claims to Medicaid.

The case was investigated by the DEA and HHS-OIG and is being prosecuted by Assistant United States Attorney Jessica Rice and Special Assistant United States Attorney Megan Curran.

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"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," Pennsylvania Attorney General Dave Sunday said. "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."

"Medicaid fraud robs hardworking taxpayers, deprives vulnerable Americans of the care they need, and undermines the public trust that sustains our social safety net," said CMS Administrator Dr. Mehmet Oz. "CMS will continue partnering with law enforcement to shut down these scams while establishing new anti-fraud safeguards that flag criminal activity before the money ever leaves the building. This Administration is taking a whole-of-government approach to protecting Medicaid - ensuring the program serves the Americans who depend on it, not criminals seeking to exploit it."

"Today's announcement underscores the need to confront Medicaid and Medicare fraud head on," stated Department of Health and Human Services Inspector General T. March Bell. "The schemes alleged here involved fabricated services, impossible work hours, and claims made while defendants were incarcerated, overseas, or working other jobs. Together with our federal and state partners, we remain steadfast in protecting Medicaid and Medicare by pursuing anyone who seeks to exploit these programs and the people they are designed to serve."

"Health care fraud is not a victimless crime - it undermines public trust and diverts critical resources from patients who need them," said FBI Philadelphia Special Agent in Charge Wayne Jacobs. "No single agency can tackle complex health care fraud schemes alone. Let today's announcement be a warning to those engaging in similar activity: if you seek to exploit our health care systems for personal profit, you should expect the FBI and our partners to uncover your scheme and bring it to an end. Every dollar stolen through fraud is a dollar diverted from patient care, and the FBI will continue its work to safeguard the public's trust and hold accountable those who abuse these vital programs."

"Health care fraud is not just a financial crime, it threatens public safety and victimizes the American people," said DEA Philadelphia Special Agent in Charge Timothy Flaherty. "Our message is clear: if you are a medical provider who chooses greed over your professional responsibility, DEA will hold you accountable."

"IRS Criminal Investigation enforces the nation's tax laws but also takes particular interest in cases involving fraud against government health care programs," said Yury Kruty, Special Agent in Charge of the IRS-CI Philadelphia Field Office. "With both law enforcement and financial investigation expertise, our agents are uniquely qualified to assist state, local and federal law enforcement agencies in these matters by tracing financial transactions. The success of these investigations is attributable to the collaborative efforts of our law enforcement partners."

On April 7, the Department of Justice announced the creation of the National Fraud Enforcement Division ("Fraud Division"). The Fraud Division is laser-focused on investigating and prosecuting those who commit fraud against the American people. The Department's work to combat fraud supports President Trump's Task Force to Eliminate Fraud, a whole-of-government effort chaired by Vice President J.D. Vance to eliminate fraud, waste, and abuse within Federal benefit programs.

The charges and allegations contained in federal indictments and state complaints are merely accusations. Every defendant is presumed to be innocent unless and until proven guilty in court.

U.S. v. Pizzo et al
U.S. v. Romsteadt et al
U.S. v. Coccia Jr et al
U.S. v. Murray
U.S. v. Bowie
U.S. v. Benevolent Home Health Care et al