Pennsylvania AG Dave Sunday leads nation in Medicaid fraud convictions

In an exclusive interview with Fox News Digital, Pennsylvania Republican Attorney General Dave Sunday described how his state became number one in the nation in convicting Medicaid fraudsters.

“As you know, Pennsylvania had the most Medicaid fraud convictions in the entire country last year. And that’s because of how aggressively we investigate and prosecute these cases,” Sunday told Fox News Digital.

“We have an absolute moral duty to protect the most vulnerable among us. One of the ways we do that is to ensure that the resources that should go to them actually get to them,” he continued.

Amid a strong push by the White House to investigate and prosecute fraud nationwide — evidenced through Vice President J.D. Vance’s White House Fraud Elimination Task Force — Medicaid fraud in particular has come to the fore.

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In May, Vance’s task force announced the indictment of a $46.6 million Minnesota Medicaid fraud scheme that Health and Human Services Secretary Robert F. Kennedy Jr. called “the largest autism fraud operation in American history.”

While high-profile fraud busts involving foreign nationals in Minnesota, California and other blue states increasingly highlight the prevalence of social services scams, Sunday’s efforts in the purple state stand out in particular.

The key to Sunday’s nationwide conviction rate, he told Fox News Digital, was his office’s emphasis on cooperation, including from his state’s Democratic governor, Josh Shapiro.

“We cooperate on a lot of issues, and this is one of the issues that our offices cooperate on. The State Inspector General’s Office works with the Pennsylvania Attorney General’s Office to make sure that we receive those complaints, and then we receive them and act with them,” Sunday explained.

In 2025, the HHS Office of Inspector General (OIG) ranked Pennsylvania’s Medicaid Fraud Control Unit number one in total fraud charges filed against individuals, while ranking Pennsylvania third in total fraud convictions for fiscal year 2024. For fiscal year 2025, the OIG ranked Pennsylvania third in charges and first in total convictions, citing a marked improvement in conviction efficiency.

“The reason we’ve been so successful, and the states that have been successful, is that they work together as a team. This is much bigger than any individual office,” Sunday told Fox News Digital.

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“You have to work hard as an office. You have to collaborate with your federal partners, your local partners, your state partners. You have to work with different service providers. This has to be a completely hands-on effort where you collaborate and coordinate with everyone humanly possible. And that’s not just to get successful prosecutions, but to get their referrals as well. People have to know what to look for,” he continued.

Pennsylvania Attorney General Dave Sunday, then a candidate for Pennsylvania attorney general, speaks during a rally on behalf of then-Republican U.S. Senate candidate Dave McCormick at the Beerded Goat Brewery in Harrisburg, Pennsylvania, on Thursday, April 25, 2024. (Tom Williams/CQ-Roll Call, Inc. via Getty Images)

His collaborative efforts and vigilance kept Pennsylvania from falling into the same trap as Minnesota, which has the seventh-most fraud convictions in 2025, according to HHS-OIG.

“The goal is to not allow these criminal organizations to take root. That’s how you do it to make sure things don’t become Minnesota. That’s how you did it. You have to stay in front of it. Every step of the way. You can never let it grow. You have to watch it when it happens. And you have to make sure you prioritize those cases, because as an AG, your time and effort can go to a million different places. But when you’re here on Sunday, we’re very focused on community safety in Pennsylvania,” he said.

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He underlined the need for cooperation, especially given the cross-border and international efforts of many convicted fraudsters. Women convicted in the Minnesota autism fraud bust sent millions of dollars in fraudulently obtained Medicaid payments back to their families in Kenya, prosecutors said.

“Remember, criminal organizations don’t care about borders and they don’t just pick and choose which jurisdiction to commit to. So cooperation can’t recognize borders either. So we work with other states. We work with other AGs’ offices across the country. We do everything we can to identify these cases and hold these actors accountable because these cases often span multiple states. So if you have an organization or criminal enterprise operating in one state, there’s a good chance they’re operating in another state as well. It’s more when we can come together and work as a team.” It allows us to make a big impact.”

On Sunday, he praised Vance’s task force as a valuable focal point that will galvanize statewide anti-fraud efforts.

Vice President J.D. Vance is joined by White House deputy chief of staff and Homeland Security advisor Stephen Miller and Federal Trade Commission (FTC) Chairman Andrew Ferguson during a roundtable discussion on anti-fraud initiatives on May 26, 2026 in Washington, DC. (Andrew Harnik/Getty Images)

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“I’m so grateful to the Vice President. I’m so grateful to Vice President Vance and his efforts to bring everyone together and create some kind of hub and conversation model where we can all work together and collaborate because that’s the only way these cases are going to be solved,” Sunday said.

He also noted cases his office has prosecuted in recent months as part of his efforts.

“We came to a big conclusion this year with Broad Street Family Pharmacy in Philadelphia. And these are people who are billing Medicaid up to $12 million for expensive medications that they often can’t even get, let alone give to someone who needs that medication to survive. So these are the kinds of cases that we really need to pursue, because when they’re making so much money, if we don’t get involved, if we don’t investigate, they’re going to keep doing it.” Digital.

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In this situation, the state blamed Nine people were involved in a wide-ranging alleged scheme that prosecutors said included fraudulent claims for HIV drugs and antipsychotic drugs, as well as a pill-buying kickback scheme.

The ringleaders of the alleged scheme, Peter Dello Buono and Frank Bengermino, were sentenced to 1.5 to 5 years in prison and ordered to pay $12.25 million in restitution. Five of the other seven have pleaded guilty to various charges, while the remaining two have pending cases.

That $12.25 million is nearly equal to the amount of federal funding Pennsylvania’s Medicaid Fraud unit receives in 2025. The HHS grant, which accounts for three-quarters of the state’s Medicaid fraud unit funding, comes in at about $12.8 million.

Sunday also revealed that the Medicaid fraud unit recovered more than four times the money it spent on investigations.

“For every dollar spent in our Medicaid section, we get $4.64 back. So think about that investment. For every dollar we spend, we get $4.64 back through our investigations and convictions. And I go back to convictions because you can get compensation through fines and convictions. And if you don’t get those convictions, then you’re going to leave a lot of that money to bad actors that you can get back to the taxpayers.”,” he told Fox News Digital.

In addition to busting apparent fraud schemes, Sunday’s office also prosecutes cases of negligence and abuse involving Medicaid plaintiffs.

“Some of these cases, especially the abuse and neglect cases, are some of the absolute most horrific cases that any prosecutor can see. I’m a career prosecutor. I’ve been doing this for a long time. And when you see elderly individuals not being provided the services that should have been provided and suffering as a result, these are cases where these individuals should not only be charged, but they should be convicted,” he said.

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He noted the case of personal care manager Kelly R. Gonzalez. a jury convicted On two counts of gross negligence in February for failing to refill a nursing home resident’s seizure medication, leading to her seizure-related death in 2021.

“Gonzalez, the defendant in this case, was assigned to supervise the prescribing of medications in this home. One of his duties was to ensure that the residents received their prescription medications,” Sunday said. “There was a victim in that home who was not taking his prescribed seizure medication. And the defendant, Gonzales, learned about this and did not administer the medication anyway.”

According to witness testimony, two of Gonzalez’s colleagues informed him that his patient needed a refill, but Gonzalez still failed to get his medication refilled.

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“It appears that the victim in this case went 10 days without medication, and of course when you’re taking serious medication, life-saving medication, and you go 10 days without medication, then there can be serious consequences,” he told Fox News Digital Sunday.

“As a result, the victim in this case died,” he concluded.

Fox News Digital has contacted the White House and Shapiro’s office for additional comment.