The U.S. House Committee on Energy and Commerce sent a letter to Governor Shapiro, pressing him on the state’s Medicaid fraud.
The House Committee on Energy and Commerce recently sent a letter to Pennsylvania Governor Josh Shapiro and Department of Human Services Secretary Valerie Arkoosh, asking the administration to detail what steps it has taken to screen Medicaid providers and disenroll fraudsters.
“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,” said the letter.
In 2020, Governor Shapiro even estimated that “it’s possible, no, likely, that Pennsylvania is losing $3 billion a year” to Medicaid fraud. The letter mentioned this admission.
The Shapiro administration responded to the letter.
“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,” wrote Shapiro spokesperson Rosie Lapowsky 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,” Lapowsky wrote.
The Energy and Commerce Committee cited data from Pennsylvania that points towards millions of dollars in possible fraud occurring in the state’s Medicaid program.
The letter said that the Commonwealth’s budget for the Department of Human Services, which administers the program, “increased 58 percent, despite the population only growing 2 percent at that time.”
The letter also referred to a 2025 press release from Attorney General Dave Sunday that included examples of fraud in Pennsylvania. Sunday’s office charged a woman for “allegedly submitting $33,000 in Medicaid claims for personal care service for a patient that was deceased.” A man also 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 Energy and Commerce Committee is asking the Shapiro administration to respond to a detailed list of questions by March 17. The letter asks for documentation of recent and ongoing Medicaid audits, program integrity measures, improper payment and recovery efforts, and more.
The letter comes as an extensive Medicaid fraud scandal was uncovered in Minnesota concerning taxpayer-funded programs related to child care and nutrition. A federal prosecutor in Minnesota has estimated the state’s Medicaid fraud to be as high as $9 billion.
