Dozens Charged With Health Care Fraud In Delaware Valley
by Alex Lloyd Gross
US Attorney David Metcalf was joined by 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 yesterday to announce the take down of several people suspected of Home Healthcare Fraud in the area.
When a person is sick, the government will pay a relative to take care of that person. The aide will fill out paperwork, get approved as a caregiver, then pay them to take care of that person. It is designed to keep people in familiar surroundings with familiar people. The aide will clock in and out on an app which keeps track of their hours.
Cooking, taking the person for appointments, cleaning up after the person are just some of the things the aide should be doing. According to Metcalf, some people were doing other things, such as sitting in prison or working other jobs. While they were clocked in on the tax payers dime.
hree federal cases were the focus of today’s takedown; the first case involves three separate indictments charging a total of eight defendants.
Alex Lloyd Gross Photo-Delaware Valley News.com US Attorney David Metcalf addresses the media.
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.
he 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.
Alex Lloyd Gross Photo Delaware Valley News.com Dr Mehmet Oz makes a point during the press conference.
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.
“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.”
Metcalf showed photos of the defendants on vacation or otherwise working other jobs while they were clocked in , supposedly taking care of someone. Often,they were supposed to be taking care of family members.
In one such case, federal agents raided a home of someone suspecting of dealing drugs. Before the person was taken into custody, they asked to clock out of the app. When asked for clarification, they were told “Everybody does it”.
Everybody does not do it, and that his how the government worked some of the cases, when allegedly dishonest people were turned in by legitimate companies.