Providers
All 18 in PA
MATTHEW J DEGIROLAMO, M.D.
NPI 1730102450, individual, Willow Grove, PA, Family Medicine
1
Evidence tier
documented action, then payment
- Listed on the Medicare revocation list since March 1, 2024.
- Medicaid still paid claims in 3 later months, $9,741 in total.
score 94 of 100, rank 290, $10K at stake
Public list actions
Medicare revocation effective March 1, 2024, barred from re-enrolling until March 1, 2034
424.535(a)(9) failure to report and 424.535(a)(3) felonies and 424.535(a)(2) provider or supplier conduct (exclusion), Practitioner - Family Practice, PA
OIG exclusion August 20, 2024 under section 1128a4
Physician (MD, DO), Family Practice, Minersville, PA
Paid after the action
Months in which Medicaid paid claims for this provider after a public action that should have triggered a screening check. This is a record of payments, not a determination that they were improper.
| list | identity check | action date | window closed | months paid after | first | last | paid after | 12 months before |
|---|---|---|---|---|---|---|---|---|
| Medicare revocation list 424.535(a)(9) failure to report and 424.535(a)(3) felonies and 424.535(a)(2) provider or supplier conduct (exclusion) | Exact NPI, name verified | Mar 1, 2024 | Mar 1, 2034 | 3 | Jun 2024 | Aug 2024 | $10K | $73K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | MATTHEW J DEGIROLAMO, M.D. |
| Type | Individual |
| Status | Active |
| NPI issued | July 25, 2006, last updated November 24, 2016 |
| Practice location | 126 EASTON RD, Willow Grove, PA 19090-3203, 215-366-7437 |
| Specialties | Family Medicine (207Q00000X, license ME81603 FL) Family Medicine (207Q00000X, primary, license MD072007L PA) |
Procedures billed
The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.
Medicaid, largest codes
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| S9083 | Medicaid service code | $349K | 100% | $103 | $113 (top 5% from $163) | 43rd percentile | |
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | $567 | 0% | $47 | $67 (top 5% from $121) | too few months to rank | |
| 99000 | Medicaid service code | $0 | 0% | $0.00 | $0.29 (top 5% from $11) | too few months to rank |
Medicare Part B 2024, largest codes
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | 14 | 14 | $691 | $175 | $114 | 1.5x | 2.4x (90th percentile 3.9x) |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 13 | 13 | $277 | $134 | $93 | 1.4x | 2.2x (90th percentile 3.8x) |
A submitted charge many times the allowed amount is common and lawful; it matters when it is far above what other providers submit for the same code.
In this area
18 providers in Montgomery County, PA carry an indicator in the public record, with $16.8M at stake between them. The most common is part of a provider network, on 11 of them, followed by more hours than a day holds on 5. 1 is tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | BERNARD OGON King Of Prussia, PA, ranked 85 | $460K |
|
| 3 | LINCOLN HEALTHCARE, LLC Conshohocken, PA, ranked 760 | $12.3M |
|
| 3 | PRESBYTERIAN MEDICAL CENTER OF THE UNIVERSITY OF PENNSYLVANIA HEALTH S Bala Cynwyd, PA, ranked 1250 | $255K |
|
| 3 | JEFFHOME PA, LLC. Horsham, PA, ranked 1441 | $42K |
|
| 3 | ND MEDICAL SOLUTIONS LLC Fort Washington, PA, ranked 2481 | $0 |
|
| 3 | ARTMAN LUTHERAN HOME Ambler, PA, ranked 2510 | $0 |
|
| 3 | PETER BECKER COMMUNITY Harleysville, PA, ranked 2638 | $0 |
|
| 3 | HOLY REDEEMER HEALTH SYSTEM Meadowbrook, PA, ranked 2897 | $0 |
|
Recent enforcement in PA
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJChargedAug 4, 2026
The Fraud Division Announces Charges Against 19 Defendants for Medicaid Home Health Aid Schemes
Nineteen defendants, including owners and employees of home care companies, home health aides, and Medicaid recipients, were charged with submitting claims for home care services that were not provided, including claims for hours when purported aides were incarcerated, hospitalized, working other jobs, or traveling overseas.
DOJIndictedJun 23, 2026
Two Doctors, Physician’s Assistant Charged With Unlawfully Distributing Controlled Substances Via Voicemail “Refill Line”
From January 2020 through March 2025 the defendants allegedly operated a voicemail refill line that allowed patients to receive refills of Schedule II controlled substance prescriptions, namely oxycodone and amphetamine, without interacting with a licensed prescriber, and submitted prescriptions in another medical professional's name to deceive pharmacies.
DOJChargedJun 23, 2026
Scranton Woman Charged With Conspiracy To Commit Bank Fraud With Funds Derived From Federal Health Care Programs
Beaubrun is alleged to have stolen and appropriated checks intended by Entity #1 for various payees, including funds derived from Medicare and Medicaid, and endorsed them to herself, causing a loss of over $300,000.
DOJCivil settlementJun 10, 2026
Ahold Delhaize USA Inc. to Pay $40M for Allegedly Reporting Inflated Drug Prices on Claims to Federal Healthcare Programs
Ahold Delhaize's in-store retail pharmacies operated prescription savings programs offering discounted prices but failed to report those discounted prices as their "usual and customary" prices on claims to Medicare Part D, Medicaid and TRICARE, causing those programs to pay inflated amounts.
DOJCivil settlementJun 10, 2026
Ahold Delhaize USA Inc. to Pay $40M for Allegedly Reporting Inflated Drug Prices on Claims to Federal Healthcare Programs
Ahold Delhaize supermarket pharmacies operated prescription savings programs offering discounted prices but failed to report those discounted prices as their "usual and customary" prices on claims to Medicare Part D, Medicaid, and TRICARE, causing those programs to pay inflated amounts.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.