Congressional Committee presses Shapiro administration on Medicaid fraud in Pennsylvania
By Todd Shepherd
A U.S. House committee is pressing the Shapiro administration on Medicaid fraud in the commonwealth, asking the governor and his human services secretary to explain what steps it has taken in recent years to combat the fraud that Shapiro himself estimated to be roughly $3 billion a year.
The Republican-controlled House Committee on Energy and Commerce sent a letter to Shapiro and Department of Human Services Secretary Valerie Arkoosh on Tuesday, asking the administration to detail what audits it has completed or may be conducting, as well as detail what other steps it is taking to screen Medicaid providers as well as disenroll fraudsters.
The letter piggybacks off of the recent revelations of Medicaid and other fraud in Minnesota so widespread it forced incumbent Governor Tim Walz (D) to abandon his re-election campaign this year.
“The swath of criminal schemes coming to light in Minnesota include overbilling, falsifying records, identity theft, and phantom claims in Medicaid social service and health programs for the elderly and disabled, children with autism, people struggling with substance use disorders, and homelessness. The Committee is concerned that your state’s Medicaid programs may be similarly vulnerable to [fraud, waste, and abuse] that harms Medicaid enrollees, legitimate providers, and taxpayers,” the letter said.
Most pointedly, the letter attempts to box Shapiro in by using his own admissions about Medicaid fraud. At a 2020 press conference, when Shapiro was attorney general, he said “it’s possible, no, likely, that Pennsylvania is losing $3 billion a year” to Medicaid fraud.
The Shapiro administration said the prod from the federal government was excessive.
“Governor Josh Shapiro has made fighting public assistance fraud a cornerstone of his career in public service, rooting out waste, fraud and abuse as Attorney General where he cracked down on fraud and public assistance benefit theft, charging dozens of people who stole millions in taxpayer dollars,” Shapiro spokesperson Rosie Lapowsky said in an email. “As Governor, his Administration has strict guidelines in place, as well as additional internal checks, to ensure taxpayer money is used for its intended purpose across Commonwealth programs and initiatives.”
“We do not wait for the federal government to compel us to act; we’ve been at this since day one and remain committed to ensuring that taxpayer dollars and public benefits only reach those who are eligible,” Lapowsky added.
She also pointed to his most recent budget address in which he called on the General Asssembly to pass a “False Claims Act” that would allow the commonwealth “to collect additional damages and recoup more state dollars that would otherwise be lost to fraud.”
The committee used numerous Pennsylvania-based data points and examples to drive home its point.
The letter said the commonwealth’s budget for the Department of Human Services, which administers the Medicaid program, “increased 58 percent, despite the population only growing 2 percent in that time,” citing a January editorial published by the right-of-center Commonwealth Foundation.
Last June, federal prosecutors announced charges against a Bensalem woman who allegedly “received kickbacks to refer home care patients to home care agencies” in a scheme that the Department of Justice says raked in more than $1 million.
The House committee letter also referenced a 2025 press release from Pennsylvania Attorney General Dave Sunday with other examples of alleged fraud, including a woman charged for “allegedly submitting $33,000 in Medicaid claims for personal care service for a patient that was deceased,” and a man who pleaded no contest to charges “related to his submission of over 400 hours of personal care services that were not rendered due to the patient being hospitalized at the time.”
The committee is asking the Shapiro administration to respond to a detailed list of questions by March 17. It asks for documentation of recent and ongoing Medicaid audits, program integrity measures such as screening integrity, improper payment and recovery efforts, and more.
Medicaid is the federal program aimed at providing health care and associated resources to persons with limited income. Although primarily a federal program, it uses a mix of federal and state dollars and relies on states to administer the funds, including oversight.
Minnesota’s fraud scandal began with taxpayer-funded programs centered on child care and nutrition, but “has since morphed into Medicaid fraud,” according to a report from PBS News.
In December, a federal prosecutor in Minnesota estimated the state’s Medicaid fraud to be as high as $9 billion across fourteen “high risk” programs.
From a Pennsylvania standpoint, the Minnesota fraud is also notable because it snared two Philadelphia residents who are now charged. Prosecutors say the men planned “to defraud Minnesota’s Housing Stabilization Services (HSS) program of approximately $3.5 million and [conceal] the scheme by using artificial intelligence to create fake records[.]”
Prosecutors have dubbed such schemes ‘fraud tourism’ — fraud so alluring that potential scammers are willing to travel the country to execute their plans.
The Trump administration’s focus on fraud comes amid ongoing unease and political campaigning about everyday affordability of housing, groceries and transportation. The president is framing fraud as one of many elements chipping away at the purchasing power of the average American. In his recent State of the Union address, Trump appointed Vice President J.D. Vance as a “fraud czar.”
Todd Shepherd is Broad + Liberty’s chief investigative reporter. Send him tips at tshepherd@broadandliberty.com, or use his encrypted email at shepherdreports@protonmail.com. @shepherdreports
