Eyeing 2028, Dem Gov Shapiro leans into fraud crackdown, boosting tough-on-crime image
Pennsylvania Gov. Josh Shapiro will announce Tuesday a landmark false claims clampdown targeting Medicaid fraud and providers that wrongfully use tax dollars.
While Shapiro has supported crackdowns on social services fraud since he was attorney general, before his governorship, the issue has reached national prominence recently amid mounting scandal enveloping fellow Democratic Gov. Tim Walz of Minnesota.
Later Tuesday, Shapiro will declare in his budget address that the state must approve a False Claims Act and signal openness to working with Republicans — who control the state Senate and are a few lawmakers short of a majority in the state House — to "get it done."
"To protect our kids and our seniors, we need to make sure every dollar we appropriate for their benefit goes to them and doesn’t get fleeced from the system," Shapiro will say, before going on to cite his work as AG to jail people who stole public benefits from fellow Pennsylvanians.
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"We combat fraud wherever we find it — and we’ve put real resources into this effort because it’s important to ensure public dollars go to the people who really need them," Shapiro will say.
Pennsylvania ranks first nationally in Medicaid fraud charges brought and third in convictions.
He will also cite the work of State Inspector General Michelle Henry — who succeeded him as attorney general — and pledge to support her efforts through cooperation among his Cabinet agencies.
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While a major Democratic figure nationally, Shapiro has a handful of Republicans in key cabinet roles, including former Philadelphia City Commissioner Al Schmidt as secretary of the commonwealth and former state Sen. Pat Browne, R-Allentown, managing the purse as secretary of revenue.
Shapiro said the commonwealth prosecuted 119 cases of Medicaid fraud in 2024, recouping $11 million that was stolen from those coffers.
The Pennsylvania Department of Human Services also referred 744 other recent suspected fraud cases to the Attorney General’s Section of Medicaid Fraud Control.
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The False Claims Act that Shapiro envisions would allow Pennsylvania to collect additional funds from convicted parties who misuse Medicaid or other social services dollars.
Shapiro will also note on Tuesday that there is already bipartisan support for such a law.
While attorney general, the then-Republican state House speaker and a top state senator joined his call for a similar plan.
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"Every instance of Medicaid abuse or fraud hurts Pennsylvanians who truly rely on the program. We are overdue for relevant and important reforms that keep closer watch over those who are taking advantage of the system, and at the same time makes the program more useful and reliable for Pennsylvanians in need," then-Speaker Bryan Cutler of Peach Bottom said in a 2020 statement.
"I applaud Attorney General Shapiro for bringing to light the glaring problems our Medicaid program faces. Every misspent or fraudulently used dollar is another dollar hard-working taxpayers have to make up for," added state Sen. Seth Grove, R-Dover.
The Shapiro administration also pointed Fox News Digital to the results of a Medicaid fraud grand jury probe empaneled by then-AG Shapiro, which served as a predicate for his announcement Tuesday.
The grand jury recommended that service providers without a "national provider identifier" number be required to specially register with Harrisburg.
Medicaid providers would also have to go through standardized training on how to properly bill Harrisburg for services rendered and be required to include the date and start-and-end times on all Medicaid forms, which are not currently required by law.
Shapiro’s efforts have had their critics, however, including the Pennsylvania Coalition for Civil Justice, a pro-tort reform group.
They expressed concern while he was attorney general that an anti-fraud plan crafted then would allow "bounty hunter" plaintiffs to seek court-ordered payouts that could reduce the amount of funds the commonwealth is able to recover.
"Wisconsin repealed its False Claims Act in 2015, and there are good reasons why many states have decided not to enact their own False Claims Act," the group told the Penn-Capital Star.
A top state hospital industry trade group also warned that, under the earlier proposal, trial attorneys would be the "only true winners," rather than patients, according to the outlet.