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Pennsylvania Attorney General Dave Sunday detailed how his state has become number one in the nation in prosecuting Medicaid fraudsters in an exclusive interview with Fox News Digital.
“As you know, in Pennsylvania we had the most Medicaid fraud cases in the country last year. And the reason for that is because of the way we investigate and prosecute these cases,” he told Fox News Digital on Sunday.
“We have a complete responsibility to protect the most vulnerable among us. And one of the ways we can do that is to ensure that the resources that are supposed to go to them get to them,” he continued.
Amid a strong campaign from the White House to investigate and prosecute fraud across the country — exemplified by Vice President JD Vance’s White House Task Force to End Fraud — Medicaid fraud has come to the fore.
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FTC Chairman Andrew Ferguson and Vice President Vance met to discuss efforts to combat fraud and improve accountability in welfare programs. (Photo by Oliver Contreras / AFP via Getty Images)
In May, the Vance team announced the indictment of Health and Human Services Secretary Robert F. Kennedy Jr. in the $46.6 million Minnesota Medicaid fraud scheme. which he called “the biggest autism fraud in American history.”
And as high profile fraud involving foreigners in Minnesota, California and other blue states highlights the rise of social services scams, Sunday’s efforts in the blue state stand out.
The key to Sunday’s record-breaking conviction rate, he told Fox News Digital, is that his office emphasizes cooperation, including with the state’s Democratic governor, Josh Shapiro.
“We collaborate on a lot of issues, and this is one of those issues that our offices collaborate on. The Office of the State Inspector General works with the Pennsylvania Attorney General’s Office to make sure we get those complaints, and then we take them and run with them,” explained Sunday.
In 2025, the HHS Office of Inspector General (OIG) ranked Pennsylvania’s Medicaid Fraud Control Unit first in fraud cases filed by individuals, while ranking Pennsylvania number three in all fraud cases in fiscal year 2024. For fiscal year 2025, the OIG ranked it third in enhancement cases and suggested that Pennsylvania has the best enhancement cases.
“The reason we’re so successful and the reason states are successful is because they work as a team. This is much bigger than any one office,” Sonto told Fox News Digital.
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“You have to work hard as an office. You have to work with your federal partners, your local partners, your federal partners. You have work with different service providers. This has to be an all-hands effort where you collaborate and connect with everyone that is humanly possible. And that’s not just to get successful prosecutions, but to get their referrals so people want to know.
Pennsylvania Attorney General Dave Sunday, then a Republican candidate for Pennsylvania attorney general, speaks during a rally for Dave McCormick, then a candidate for the US Senate, at the Beerded Goat Brewery in Harrisburg, Pa., Thursday, April 25, 2024. (Tom Williams/CQ-Roll Call, Inc via Getty Images)
His cooperative efforts, combined with vigilance, prevented Pennsylvania from falling into the same trap as Minnesota, which had the seventh-highest rate of fraud in 2025, according to HHS-OIG.
“The goal is not to let those criminal enterprises take root. That’s the way you have to do this to make sure it doesn’t turn into Minnesota. That’s the way you can do it. You have to stay ahead of it. Every step of the way. You can’t let it grow. You have to watch it if it happens. And you have to make sure you prioritize these areas, because the AG can prioritize these areas, because your million time can go. You’re like here in Pennsylvania, we’re very focused on public safety,” Sunday said.
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He expressed the need for cooperation, especially given the cross-border and international efforts of many convicted fraudsters. Women convicted of fraud in Minnesota autism were sending millions of dollars in Medicaid payments to their families in Kenya, prosecutors say.
“Remember, criminal enterprises, they don’t care about borders and they don’t pick and choose which area they will stick to. And so cooperation will know no borders. So we are cooperating with other states. We are working all over the country with other AG offices. We are doing everything we can to identify these cases and hold these actors to account because if this happens in many countries it will happen. A criminal enterprise that operates in one state, there is a good chance that it operates in another state and so if we can meet and working as a team, that allows us to have an even greater impact.
On Sunday, he praised the Vance team as an important place to boost anti-fraud efforts across the country.
Vice President JD Vance is joined by White House deputy chief of staff and Homeland Security adviser 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 very thankful for the Vice President. I’m thankful for Vice President Vance and his efforts to bring everyone together and to kind of create a platform and talk about a model where we can all work together and cooperate because that’s the only way these cases will be solved,” said Sunday.
He also highlighted cases that his office has prosecuted in recent months as part of their efforts.
“We had a big case this year with Broad Street Family Pharmacy in Philadelphia. And these are people who were billing Medicaid up to $12 million for expensive drugs that they often couldn’t even get, let alone give to someone who needed those drugs to stay alive. So those are the kinds of cases that we really have to go after, because if they’re making that much money, if we don’t invest it, we didn’t invest it much. They’re going to continue to do it,” he told Fox News Digital.
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In that case, the state charged nine people with an alleged scheme that prosecutors say included fraudulent claims for HIV drugs and antipsychotic drugs, as well as a conspiracy to buy recovery pills.
The alleged ringleaders of the scheme – Peter Dello Buono and Frank Bengermino – were sentenced to between 1.5 and five years in prison and ordered to pay $12.25 million in restitution. Five of the seven pleaded guilty to various charges, while the remaining two have pending charges.
That $12.25 million is about the same amount of federal funding that Pennsylvania’s Medicaid Fraud unit received in 2025. HHS funding that makes up three-quarters of the funding for the state’s Medicaid fraud unit comes in at about $12.8 million.
Church also revealed that the Medicaid fraud unit recovered four times the amount it spent on the investigation.
“For every dollar spent on our Medicaid division, we get $4.64. So think about that investment. For every dollar we spend, we get $4.64 on our investigations and our convictions. And I go back to our sentencing because you can get restitution with sentences and convictions. And if you can’t get those convictions, you’re going to leave a lot of tax on that tax that you can get a lot of tax back on.,” he told Fox News Digital.
In addition to cracking open fraud schemes, Sunday’s office also prosecutes cases of neglect and abuse involving Medicaid applicants.
“Some of these cases, especially cases of abuse and neglect, are some of the most horrific crimes that any prosecutor can see. I am a career prosecutor. I have been doing this for a long time. And if you see the services that should be provided and you see the elderly, who are being abused, those who are in pain need those individuals, but those who are in pain just need to face the pain. They must be punished,” he said.
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He pointed to the case of Kelly R. Gonzalez, a personal care manager who was convicted by a jury of two counts of negligence in February when she failed to refill a resident’s seizure medication that led to her 2021 seizure death.
“The defendant in this case, Gonzalez, was given the task of overseeing the supply of medicines in this home. One of his tasks was to ensure that the residents receive the prescribed medicines,” said Sunday. “There was a resident in that home, the victim, who did not receive the prescribed anticonvulsant medication. And the defendant, in this case, Gonzales, found out about it and did not give the medication.”
According to witness testimony, two of Gonzalez’s colleagues informed him that his patient needed a refill, but he still failed to receive his medication.
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“Obviously the victim in that situation went 10 days without medication, and obviously if you take a serious drug, a life-saving drug and you go 10 days without it, it can have serious consequences,” Sonto told Fox News Digital.
“So because of that the victim in this case died,” he concluded.
Fox News Digital has reached out to the White House and Shapiro’s office for further comment.
