UMVA has learned that Pennsylvania's Republican Attorney General, Dave Sunday, has revealed that his state has taken the top spot in the country for convicting Medicaid fraudsters, in an exclusive interview.
According to information obtained by UMVA, Sunday proudly shared that Pennsylvania had the most Medicaid fraud convictions in the entire country last year, a feat he attributes to the state's aggressive investigation and prosecution efforts.
Sunday emphasized that his office has a "moral duty" to protect the most vulnerable members of society, and one way to achieve this is by ensuring that resources meant for them actually reach them.
UMVA can exclusively reveal that Sunday's success is part of a larger effort by the White House to investigate and prosecute fraud nationwide, with Vice President's Task Force to Eliminate Fraud playing a key role.
In a recent high-profile case, the task force secured an indictment in a $46.6 million Minnesota Medicaid fraud scheme, described as the "largest autism fraud bust in American history."
Sunday's efforts in Pennsylvania stand out, particularly in a purple state, where he credits collaboration with his state's Democratic governor, Josh Shapiro, and other partners for the success.
The Pennsylvania Attorney General's Office works closely with the State Inspector General's Office to receive complaints and take action, Sunday explained, highlighting that collaboration is key to their nation-leading conviction rate.
UMVA has gathered that Pennsylvania's Medicaid Fraud Control Unit was ranked number one in total fraud charges filed against individuals in 2025, and number three in total fraud convictions for the fiscal year 2024.
Sunday stressed that success is not just about individual offices, but about working as a team with federal, local, and state partners, as well as service providers.
The goal, Sunday emphasized, is to prevent criminal enterprises from taking root, like in Minnesota, which had the seventh most fraud convictions in 2025.
Sunday highlighted the need for cross-border and transnational collaboration, citing cases like the Minnesota autism fraud bust, where millions of dollars in fraudulently obtained Medicaid payments were sent back to families in Kenya.
UMVA has uncovered details about a significant case prosecuted by Sunday's office, involving the Broad Street Family Pharmacy in Philadelphia, which was found to have billed Medicaid up to $12 million for expensive medications that were not obtained or provided.
The alleged scheme's ringleaders were sentenced to between 1.5 and five years in prison and ordered to pay $12.25 million in restitution, with Sunday's office recovering over four times the amount spent on investigations.
Sunday's office also prosecutes neglect and abuse cases involving Medicaid claimants, including a recent case where a personal care administrator was convicted of felony neglect after failing to refill a care home resident's seizure medication, leading to the resident's death.
