PHILADELPHIA, PA — Federal prosecutors have charged 12 individuals and one home health agency in a series of indictments alleging schemes to defraud Pennsylvania’s Medicaid program, while the U.S. Department of Justice also announced the expansion of its Northeast Health Care Fraud Strike Force into Philadelphia.
U.S. Attorney David Metcalf announced the charges Tuesday alongside officials from the Department of Justice, the Pennsylvania Attorney General’s Office, the FBI, the Department of Health and Human Services Office of Inspector General, the Drug Enforcement Administration, the Internal Revenue Service Criminal Investigation division, and the Centers for Medicare & Medicaid Services.
According to prosecutors, the cases allege fraudulent billing for home health care services that were never provided, including claims submitted while caregivers were allegedly incarcerated, hospitalized, traveling overseas, working other jobs or, in one case, deceased.
The largest of the federal cases includes three indictments charging eight Philadelphia defendants with conspiracy to commit health care fraud and health care fraud offenses involving an unnamed home care provider identified in court records only as “Agency 1.”
According to the indictments, Joseph Pizzo, 47, and Tiziana Taormina, 52, allegedly caused Medicaid to pay more than $160,000 for home care services that prosecutors contend were billed while Pizzo was incarcerated or working a construction job.
A separate indictment charges Donna Romsteadt, 63, Alyssa Cuculino, 27, Louise Israel, 46, and Elexis Cuculino, 51, with allegedly participating in a similar billing scheme that prosecutors claim generated approximately $445,000 in fraudulent Medicaid payments. According to the indictment, aides allegedly billed for services while working another job, hospitalized or incarcerated, while Medicaid recipients allegedly assisted by completing fraudulent clock-ins.
A third indictment charges Albert Coccia Jr., 56, and Santino Coccia, 28, with conspiracy and health care fraud. Prosecutors allege Santino Coccia billed Medicaid for providing care to his father while working as a rideshare and food-delivery driver, resulting in more than $211,000 in fraudulent claims.
In a second federal case, prosecutors charged Sean Murray, 58, and Charles Bowie, 53, both of Philadelphia, with health care fraud and multiple counts of wire fraud.
According to the indictments, Murray allegedly billed Medicaid for home care services while at a gym, massage parlor, traveling or selling illegal drugs, generating approximately $400,000 in claims. Bowie is accused of submitting approximately $600,000 in fraudulent billings while allegedly vacationing in Saudi Arabia, Jamaica, Colombia and other destinations.
A third federal indictment charges Khaleelah Williams, 49, Saleemah Davis, 29, and their company, Benevolent Home Health LLC, with conspiracy, health care fraud, wire fraud and aggravated identity theft.
Prosecutors allege the defendants billed Medicaid for services purportedly provided by an aide who was deceased and by Williams’ husband while he was allegedly engaged in drug trafficking and after he was detained on federal drug charges. The indictment alleges approximately $224,000 in fraudulent Medicaid claims.
The announcement also marked the expansion of the Department of Justice’s Northeast Health Care Fraud Strike Force into the Eastern District of Pennsylvania. According to the Justice Department, the Strike Force combines prosecutors from DOJ’s Health Care Fraud Section with the U.S. Attorney’s Office to investigate and prosecute complex health care fraud cases. Nationally, the Strike Force has prosecuted more than 6,200 defendants accused of billing more than $45 billion in fraudulent claims.
The investigations were conducted by multiple federal agencies, including the FBI, HHS Office of Inspector General, DEA and IRS Criminal Investigation, with assistance from the Pennsylvania Office of Attorney General. The various cases are being prosecuted by attorneys from the Department of Justice’s Health Care Fraud Strike Force and the U.S. Attorney’s Office for the Eastern District of Pennsylvania.
All suspects, arrestees, and defendants are presumed innocent until proven guilty in a court of law.
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