DOJ opens permanent fraud strike-force office in Philadelphia

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DOJ opens permanent fraud strike-force office in Philadelphia

Plus: CMS releases autism therapy billing oversight toolkit for states. The day's rules, money, and enforcement, sourced and tiered below.

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The Justice Department just opened a permanent fraud-fighting office inside Philadelphia's federal prosecutor's headquarters, and its first case already charges 19 people in home-care Medicaid schemes.

Prosecutors say the schemes billed Pennsylvania Medicaid $5.76 million, including an aide who kept billing while incarcerated. The strike-force model has now prosecuted 6,200+ people who billed $45 billion nationally.

Record

The Medicare and Medicaid agency just told states to tighten billing oversight of autism therapy, the behavioral treatment covered for children on Medicaid, after spending on it exploded 421 percent since 2021.

That growth outpaced the rise in diagnosed children served by 6 to 1. HHS Secretary Robert F. Kennedy Jr. says the new playbook targets "fraud schemes that exploit children with autism," not eligibility itself.

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