United States v. Hemal Patel - Information (Counts One and Two)

Aug 30, 2026

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Charging information filed in the United States District Court for the Eastern District of Pennsylvania against Hemal Patel. The document sets out the alleged background and statutory bases for the charges, describing entities involved in personal assistance services under Pennsylvania’s Community HealthChoices (CHC) Home and Community-Based Services program and the use of Electronic Visit Verification (EVV). It further outlines roles of service providers, recipients, managed care organizations, and the EVV capture and check-in/check-out process.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages17

Reading Time43 min

AccessFree to download

Background

Parties and roles

Medicaid and CHC waiver program

Personal assistance services

EVV program and data capture

Billing and check-in/check-out

IN THE UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF PENNSYLVANIA UNITED STATES OF AMERICA v. HEMAL PATEL : CRIMINAL NO. 25 : DATE FILED : VIOLATIONS: : 18 U.S.C. § 1343 (wire fraud – 2 counts) : 18 U.S.C. § 1028A (aggravated identity theft – 2 counts): 18 U.S.C. § 371 (conspiracy – 1 count): Notice of forfeiture INFORMATION COUNTS ONE AND TWO THE UNITED STATES ATTORNEY CHARGES THAT: At all times material to this information: BACKGROUND 1. Defendant HEMAL PATEL was a resident of the Eastern District of Pennsylvania. 2. Person-1, known to the United States Attorney, was a resident of Bucks County, in the Eastern District of Pennsylvania. 3. Agency-1, known to the United States Attorney, was a licensed provider of personal assistance services based in Bucks County, in the Eastern District of Pennsylvania, and was solely owned and operated by Person-1. 4. EVV-1 was a third-party provider of Electronic Visit Verification (“EVV”) software and web-based platforms. EVV-1 used a web service to host its platform on servers that were located in the Commonwealth of Virginia. 5. PCA-1, an individual known to the United States Attorney, resided in New Jersey and was employed as a personal care assistant (“PCA”) through Agency-1 . 6. PCA–2, an individual known to the United States Attorney, resided in Bucks County, in the Eastern District of Pennsylvania, and was employed as a personal care assistant through Agency-1 . 7. Victim-1 and Victim-2, individuals known to the United States Attorney, each resided in Montgomery County, in the Eastern District of Pennsylvania. 8. Medicaid was a health care benefit program jointly funded by federal and state governments. On the federal side, Medicaid was overseen by the Centers for Medicare and Medicaid Services (“CMS”) of the United State Department of Health and Human Services (“HHS”) . On the state side, in Pennsylvania, Medicaid was overseen by the Pennsylvania Department of Human Services (“DHS”) . A person covered by Medicaid was referred to as a recipient, a consumer, or a beneficiary. 9. CMS allowed states to apply for various Home and Community-Based Services (“HCBS”) waiver programs authorized in Section 1915(c) of the Social Security Act. HCBS waiver programs permitted a state to furnish an array of home and community-based services that would assist Medicaid beneficiaries to live in the community and avoid institutionalization. CMS allowed states latitude to design a HCBS waiver program that addressed the specific needs and goals of the state. 10. Pennsylvania designed and received CMS approval for a HCBS waiver program called Community HealthChoices (“CHC”) . CHC allowed Medicaid to pay for, among other things, home and community-based personal assistance services for those recipients who otherwise would need to live in a nursing home because of disability. CHC required Medicaid recipients to enroll with a managed care organization (“MCO”) to receive long-term services and supports, including personal assistance services, and physical health services, such as obtaining medical care and treatment. 11. Personal assistance services were aimed at assisting the recipients with completing their daily living activities, performing health maintenance activities, providing routine support services, accompanying individuals into the community, and providing incidental homemaker tasks such as eating, bathing, and toileting. For Medicaid recipients who could only live outside of an institutional setting with assistance performing activities of daily living, a personal care assistant (“PCA”) was assigned to provide personal assistance services paid for by Medicaid. To apply for this program, an applicant had to contact the Pennsylvania Independent Enrollment Broker, who then requested a completed physicians’ certification form from the applicant’s doctor. The form could be electronically signed or signed with a wet signature. In addit

FAQs

What program and services are described in the charging background?

The background explains Pennsylvania’s Community HealthChoices (CHC) Home and Community-Based Services waiver, under which Medicaid funds home and community-based personal assistance services for eligible recipients.

How does Electronic Visit Verification (EVV) work in the document?

EVV electronically verifies the delivery dates and times of services by capturing details such as service type, recipient, service date, provider identity, and start/end times, using telephone, computer, or a mobile application.

Who is responsible for EVV check-in and check-out?

The document states that a personal care assistant (PCA) is responsible for checking in and checking out for each shift using EVV.

Aug 30, 2026

Upload by Maeve