The Justice Department's expanded anti-fraud task force made its first major bust in Pennsylvania this month, charging 19 defendants with schemes that prosecutors described as brazen attempts to steal from a program serving elderly and disabled residents. The cases drew immediate comparisons to the massive Medicaid fraud scandal that has rocked Minnesota — but officials noted a key difference: Pennsylvania's Democratic governor is actively cooperating with federal investigators.
Pennsylvania spends $8 billion annually on Medicaid home-care services, among the highest of any state. That scale, combined with a 20% increase since 2018 in adults enrolled in home-care programs, drew scrutiny from CMS Administrator Mehmet Oz and his team as part of an effort to put all 50 governors on notice over billions lost to fraud.
What the Right Is Saying
Republican Rep. Lloyd Smucker of Pennsylvania called the alleged schemes deeply troubling, drawing direct parallels to Minnesota's scandal. "The allegations are really disturbing just as they are in Minnesota and other places where we've seen this," Smucker told Fox News Digital in an exclusive interview.
Smucker, a member of the House Ways & Means Committee, emphasized that Medicaid serves vulnerable populations who depend on the program for daily assistance. "This is criminal activity taking money from individuals who really need it — people who are disabled and relying on Medicaid to get through every day," he said. "These are criminals lining their pockets."
Republicans have pointed to Pennsylvania's high number of home-care service providers as a factor worth examining, noting that critics in Minnesota and Washington state have raised similar concerns about provider numbers and suspicious billing patterns. The party has broadly backed Dr. Oz's efforts to hold states accountable for detecting and prosecuting fraud.
What the Left Is Saying
Democratic Gov. Josh Shapiro, who previously served as Pennsylvania's attorney general prosecuting public assistance crimes, positioned the state as a national leader in fighting fraud. "Here in Pennsylvania, we combat fraud wherever we find it," Shapiro said in a statement. "In 2024, we charged 119 cases of Medicaid fraud — recovering more than $11 million for taxpayers."
Shapiro's office emphasized that cooperation with federal authorities sets Pennsylvania apart from Minnesota, where Gov. Tim Walz has faced Republican accusations of inaction over what has become a multibillion-dollar scandal. Shapiro spokesperson Rosie Lapowsky told Fox News Digital that the Pennsylvania Department of Human Services brought one of the cases cited by prosecutors to the Justice Department for further investigation. "Clearly showing our system works," she said.
Democratic lawmakers have generally supported the anti-fraud task force, with some noting that rooting out abuse protects legitimate providers and ensures resources reach those who genuinely need care. The party has emphasized that fraud exists across political lines and that bipartisan cooperation is essential to addressing it effectively.
What the Numbers Show
According to DOJ anti-fraud chief Colin McDonald, some of the most egregious Pennsylvania cases included defendants who billed Medicaid while engaged in other activities: one suspect allegedly billed for services during a traffic stop where police charged him with marijuana possession; another billed while sitting in court watching a family member sentenced for Medicaid fraud. A third billed for home-care services while working as a rideshare driver, and a fourth billed for services while incarcerated.
Pennsylvania's 2024 data shows 119 Medicaid fraud cases charged, recovering more than $11 million for taxpayers. The state has recorded the nation's highest number of criminal convictions for Medicaid fraud. Pennsylvania's adult home-care enrollment increased 20% between 2018 and now, according to DHS figures. The commonwealth ranks fifth nationally in population behind California, Texas, Florida and New York.
The DOJ noted that Pennsylvania spends $8 billion on Medicaid home-care services annually — more than almost any other state — making it a significant target for fraudulent activity.
The Bottom Line
Pennsylvania's cooperation with the federal anti-fraud task force contrasts sharply with ongoing controversies in Minnesota, where Gov. Walz has faced bipartisan criticism over handling of that state's scandal. Dr. Oz and CMS have made clear they expect all governors to prioritize fraud detection or face federal consequences. What happens next will likely depend on whether Pennsylvania's model of state-federal coordination produces measurable results — and whether other states follow suit or resist the pressure.