The Federalist By: M.D. Kittle 2/25/2026
Open the Books’ investigation found Pennsylvania saw Medicaid payments soar from $5.6 million to $583 million over seven years. In June, a Pennsylvania woman appeared in federal court in connection with a $1 million-plus home care fraud scheme. Hemal Patel was charged with wire fraud, aggravated identity theft, and conspiracy to violate the federal anti-kickback statute. The 59-year-old Bucks County resident, according to the U.S Attorney’s Office for Pennsylvania’s Eastern District, pocketed payments for referring patients to home care agencies. Patel and others schemed to fraudulently bill Medicaid for ghost home care services.
The scam targeted Pennsylvania’s Community HealthChoices, which uses Medicaid funds to pay for home- and community-based personal assistance services for individuals with disabilities to help keep them out of nursing homes, according to court filings. Patel was one of hundreds of people charged in the Department of Justice’s National Health Care Fraud Takedown, the largest sweep of its kind covering some $14.6 billion in intended Medicaid losses.
Payouts to personal assistance services have ballooned nationally. Between 2018 and 2024, Medicaid cash in the category grew by 144 percent, from $9.6 billion to almost $23.5 billion. But payments have absolutely exploded in Pennsylvania — by more than 10,000 percent over the period, according to an analysis of new data from the Centers for Medicare and Medicaid Services (CMS). The massive data dump, reviewed by public spending tracker Open the Books, shows Medicaid-funded payments to Pennsylvania’s personal assistance services shot up from $5.6 million in 2018 to $583 million in 2024.
The massive increases should be of particular interest for CMS Administrator Dr. Mehmet Oz, the former TV personality who claimed the Keystone State as his home state during his 2022 U.S. Senate run.
Amber Todoroff, Public Policy Researcher at OTB, said Pennsylvania Gov. Josh Shapiro’s office did not respond to the organization’s request for comment. Nor did the state health agency that administers the program, overseeing the 10,000 percent spike in payments.
“Certainly they should be made to answer for this program,” Todoroff told me Tuesday on NewsRadio 1110 KFAN in Omaha.
Amid escalating welfare fraud, particularly the multi-billion dollar ripoff in Gov. Tim Walz’s fraud-riddled Minnesota, CMS has released an unprecedented amount of data in the name of transparency. The data include north of 270 million payments made by Medicaid nationwide over the seven-year period, OTB reported.
“Payment amounts generally increased over time, with a notable bump starting in 2020 in response to COVID-related spending and increased enrollment due to economic hardship caused by government-imposed economic shutdowns,” the government watchdog noted in its report, provided to The Federalist.
Not surprisingly, New York, California, and Texas booked the highest amount of Medicaid payments. New York, for instance, paid out $142 billion-plus on 15.7 million claims over the period, according to OTB’s investigation. California topped $127.6 billion in Medicaid spending on 30.7 million claims, and Texas ranked third with $64.5 billion and 12.8 million claims. The top 10 states accounted for $605 billion in spending, more than half of all Medicaid spending during the period, Open the Books found.
More:
https://thefederalist.com/2026/02/25/report-state-medicaid-payments-explode-as-fraud-scandals-grow/
