HARRISBURG, Pa. – A Philadelphia man has been convicted of Medicaid fraud and related crimes after falsely claiming to have provided home care for his mother-in-law. The fraudulent activities resulted in the Medicaid program paying over $4,200 for services that were never rendered. The verdict was delivered by a Montgomery County jury following two days of testimony regarding the defendant, Felipe L. Santos, and his deceitful actions between October 2020 and May 2021.
Santos, 30, was found guilty of four counts of Medicaid fraud, four counts of tampering with public records, and theft by deception, all of which are felony charges. The sentencing is scheduled for a later date in May. Attorney General Michelle Henry stressed the importance of prosecuting such crimes to maintain the integrity of the healthcare system and ensure that Pennsylvanians receive proper care.
An investigation conducted by the Office of Attorney General revealed that Santos had submitted false claims of providing home care services on multiple occasions when his mother-in-law was actually being treated in hospitals. The hours were then invoiced to the Philadelphia-based home care agency, Help at Home, which sought reimbursement from PA Health and Wellness, a Medicaid-funded managed care organization.
Santos fraudulently claimed at least 262.5 hours of service, amounting to at least $4,297.74 in payments from Medicaid. The trial brought to light his intentional manipulation of the system, leading to financial losses and potential harm to patients who should have received genuine care.
Senior Deputy Attorney General Jason Karasik led the prosecution of the case, emphasizing the diligent efforts of investigators and prosecutors in holding the defendant accountable. The conviction highlights the commitment of the Pennsylvania Medicaid Fraud Control Unit in combating fraudulent activities within the healthcare system.
It is worth noting that the Pennsylvania Medicaid Fraud Control Unit receives funding from the U.S. Department of Health and Human Services, as well as from the state of Pennsylvania, to support its operations. The unit plays a crucial role in ensuring the proper allocation of resources and safeguarding the integrity of the Medicaid program.
The conviction of Felipe L. Santos serves as a reminder of the ongoing battle against fraudulent activities targeting healthcare programs. Authorities continue to prioritize the prosecution of individuals who exploit the system, aiming to prevent financial losses and protect the well-being of patients in need. The sentencing of Santos will further underscore the consequences faced by those who engage in Medicaid fraud and related crimes.
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