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

Department of Justice Announces Health Care Fraud Strike Force in Philadelphia 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. 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 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. 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.