On August 4, 2026, the U.S. Department of Justice (DOJ) announced the establishment of a new Health Care Fraud Strike Force in the Eastern District of Pennsylvania (EDPA) as part of the continued build-out of the DOJ's efforts to target healthcare fraud. The EDPA initiative will be staffed in a partnership between the DOJ's Health Care Fraud Unit and the EDPA U.S. Attorney's Office, working alongside the Department of Health and Human Services Office of Inspector General (HHS-OIG) and federal law enforcement agencies. 

The announcement accompanied criminal charges against 19 defendants in multiple Medicaid home health aide fraud schemes, underscoring the DOJ's commitment to directing additional investigative and prosecutorial resources toward regions viewed as presenting significant fraud risks. 

Expansion of Task Force Enforcement Model

The EDPA expansion further shows the DOJ's intent to continue deploying the Strike Force model more broadly, using coordinated investigations, parallel criminal, civil, and administrative enforcement tools, and leveraging modern data-driven investigation techniques. The new Strike Force office will operate as part of the DOJ's Northeast Health Care Fraud Strike Force, which operates in coordination with the U.S. Attorneys' Offices for the Eastern District of New York and the District of New Jersey, as well as industry partners. The Philadelphia office joins a series of recent Strike Force expansions, including in Massachusetts, Minnesota, Northern California, Arizona, and Nevada. According to the DOJ, the Health Care Fraud Strike Force program thus far has prosecuted more than 6,200 defendants who collectively billed federal healthcare programs and private insurers more than $45 billion, relying in part on data analytics of Medicare and Medicaid claims.

As discussed in our prior alerts regarding the DOJ's expanding healthcare enforcement initiatives, including the West Coast Health Care Fraud Strike Force and the reinstitution of the DOJ/HHS False Claims Act Working Group, these increasing and highly publicized enforcement actions signal that healthcare fraud remains among the DOJ's highest enforcement priorities.

Emphasis on Corporate Accountability 

Notably, the DOJ used the August 4 announcement to highlight the Health Care Fraud Unit's growing emphasis on corporate enforcement, linking to the department's recently released Corporate Enforcement and Voluntary Self-Disclosure policy. In describing the rationale for the EDPA expansion, the DOJ emphasized the Philadelphia U.S. Attorney's Office's history of significant healthcare litigation and enforcement activity (including recent corporate resolutions with AP of South Florida LLC, Atlantic Biologicals Corp., ExThera, and Troy Health, Inc.) and the recent declination of intervention in proceedings against eye care group Campus Eye based on its self-disclosure. 

This emphasis on corporate wrongdoing is consistent with broader DOJ messaging in recent months that encourages healthcare companies to identify misconduct, strengthen compliance programs, and consider voluntary self-disclosure where appropriate. The DOJ's repeated references to corporate accountability suggest that enforcement efforts will continue to target not only individual providers and beneficiaries, but also management, owners, private equity-backed entities, billing organizations, and other corporate participants in the healthcare ecosystem.

Focus on Medicaid and Home Health Services

The 19 cases announced as part of the Strike Force expansion involved alleged Medicaid home care fraud schemes, including claims for hundreds of thousands of dollars of home care services purportedly rendered while aides were incarcerated, hospitalized, out of the country, working other jobs, or otherwise unable to provide care. In recent years, federal and state enforcement agencies have increasingly focused on Medicaid-funded home- and community-based services, where large beneficiary populations, decentralized service delivery models, and electronic visit verification systems generate significant audit and investigative opportunities.

Organizations operating in home health, personal care services, behavioral health, durable medical equipment, managed care, and related sectors should expect continuing federal scrutiny, particularly where billing, documentation, supervision, or eligibility controls may present compliance vulnerabilities.

Key Compliance Takeaways

The EDPA Strike Force expansion offers several practical lessons for healthcare organizations:

Expect Increased Use of Data Analytics. In addition to traditional whistleblower cases, healthcare fraud investigations increasingly originate from claims analysis, utilization reviews, and data mining techniques that identify billing anomalies. Organizations should evaluate their own data-monitoring capabilities to identify potentially aberrant claims patterns before regulators do.

Revisit Compliance Program Effectiveness. The DOJ's emphasis on corporate accountability reinforces the importance of maintaining compliance programs that are appropriately designed, adequately resourced, and capable of detecting misconduct. Organizations should assess whether controls are keeping pace with operational growth and evolving risk areas, conducting formal risk assessments where needed.

Evaluate Self-Disclosure Considerations. The DOJ's reference to its recent corporate declination underscores its continuing prioritization of voluntary self-disclosure. Companies confronting potential fraud issues should consider whether disclosure, cooperation, and remediation may offer meaningful benefits under current enforcement policies.

Prepare for Parallel Enforcement. The Strike Force model typically involves close coordination among criminal prosecutors, civil enforcement attorneys, HHS-OIG, the Centers for Medicare & Medicaid Services (CMS), and other agencies. Organizations should be prepared for investigations that can create simultaneous criminal, civil, and administrative exposure.

Looking Ahead

The establishment of the EDPA Health Care Fraud Strike Force is the latest indication that the DOJ will continue to expand healthcare fraud enforcement capabilities and deploy additional resources to this enforcement priority. Combined with the creation of the DOJ's National Fraud Enforcement Division, record-setting national healthcare fraud takedowns, and renewed emphasis on corporate accountability, the announcement shows that healthcare fraud investigations will remain a central focus of federal enforcement efforts. 

Healthcare providers, management companies, investors, and others operating in the sector should take this opportunity to reassess fraud and abuse risks, test internal controls, and ensure that compliance and investigative response processes are positioned to address the increasingly aggressive enforcement environment.

For more information, please contact:

Joshua Drew, jdrew@milchev.com, 202-626-5811

Bradley E. Markano, bmarkano@milchev.com, 202-626-6061

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