Pennsylvania News: TWELVE INDIVIDUALS CHARGED IN EXTENSIVE HEALTH CARE FRAUD CONSPIRACY TO DEFRAUD MEDICAID HOME CARE PROGRAM

Sixteen Defendants Have Been Charged to Date in Connection with the Conspiracy

PITTSBURGH, Pa. – Ten residents of Western Pennsylvania, a resident of Georgia, and a resident of South Carolina were charged by a federal grand jury in a 22-count indictment related to a years-long conspiracy to defraud the Pennsylvania Medicaid program, United States Attorney Scott W. Brady announced today.

Arlinda Moriarty, Daynelle Dickens, Julie Wilson, Tamika Adams, Tony Brown, Terry Adams, Terra Dean, Tionne Street, Keith Scoggins and Larita Walls, all residing in and around Pittsburgh, Pennsylvania, along with Larita Walls, a resident of South Carolina, and Luis Columbie-Abrew, a resident of Georgia, are charged with one count each of conspiracy to commit health care fraud and health care fraud. Moriarty, Dickens, Wilson and Tamika Adams are also charged with one count of concealing material facts in relation to a health care matter. In addition, Moriarty, Tamika Adams and Columbie-Abrew each are charged with multiple counts of aggravated identity theft.

According to the Indictment, between January 2011 and April 2017, home health care companies owned and operated by the conspirators received more than $87,000,000 in Medicaid payments. During that time, all 12 of the defendants, along with other individuals, participated in a wide-ranging criminal conspiracy to defraud the Pennsylvania Medicaid program which resulted in the payment of millions of dollars in illegal Medicaid payments. The Indictment sets forth dozens of fraudulent acts by the defendants, including making false claims for services that were never provided, creating fake employees, improperly using consumers’ personal identifying information, and falsifying documentation during state audits of the companies. In some instances, the Indictment alleges that the defendants were actually working at other jobs or living out of the area. In other instances, Medicaid claims were submitted for services for consumers who were actually hospitalized, incarcerated, or deceased.

“Home health care programs are critical to the ability of patients with serious physical limitations, especially the elderly, to receive the care they need while remaining independent. Those who provide home health care are expected to deliver services honestly,” said U.S. Attorney Brady. “When criminals cheat and steal from these programs, they not only steal from the taxpayers, but they steal from the most vulnerable members of our community.”

“Health care fraud diverts taxpayer dollars and lines the pockets of dishonest health care providers,” said FBI Special Agent in Charge Robert Jones. “The FBI will continue to aggressively investigate these cases and work with our state and federal partners to ensure those who commit Medicaid fraud are prosecuted.”

“Ensuring the safety of Medicaid beneficiaries is of the upmost importance,” said Maureen R. Dixon, Special Agent in Charge of the Office of Inspector General for the U.S. Department of Health and Human Services in Philadelphia. “We will continue to work with the U.S. Attorney’s Office and all our fellow law enforcement partners, to aggressively investigate allegations of fraud, waste, and abuse in HHS programs.”

“Criminals who commit Medicaid fraud are stealing tax dollars that cannot be put to use caring for vulnerable Pennsylvanians who need assistance,” said Pennsylvania Attorney General Josh Shapiro. “That’s why my Medicaid Fraud Control section worked closely with U.S. Attorney Brady and other federal law enforcement partners on this investigation. We’ll investigate and prosecute health care fraud wherever we find it.”

Tommy Coke, Postal Inspector in Charge of the Pittsburgh Division stated, “This investigation was an excellent example of partnership among the law enforcement agencies, working together to bring down a health care fraud conspiracy. I fully commend the hard work and countless hours put forth by all of the law enforcement agencies involved, which resulted in bringing the individuals in this scheme to justice.”

“This indictment is the byproduct of a joint investigative effort and is the first step toward holding these individuals accountable for their actions”, said Guy Ficco, Special Agent in Charge of IRS-Criminal Investigation. “The Agents of IRS-CI will continue working with our fellow law enforcement partners on these types of investigations by using our financial expertise to trace the flow of money.”

In addition to the 12 defendants charged in the Indictment, four other defendants—Travis Moriarty, Tiffhany Covington, Brenda Lowry and Autumn Brown—have been charged in separate criminal Informations for their involvement in the conspiracy to commit health care fraud.

The conspiracy and health care fraud charges each carry a maximum total sentence of not more than 10 years in prison, a fine of $250,000, or both. The concealment of material facts in relation to a health care matter charge carries a maximum total sense of not more than five years in prison, a fine of $250,000, or both.

The aggravated identity theft charges carry a mandatory sentence of two years in prison to run consecutively with any sentence imposed on any other charge and a fine of no more than $250,000. Under the Federal Sentencing Guidelines, the actual sentence imposed would be based upon the seriousness of the offense and the prior criminal history, if any, of the defendants.

An indictment is an accusation. The defendants are presumed innocent unless and until proven guilty.

Assistant United States Attorneys Eric G. Olshan and Special Assistant United States Attorney Edward Song are prosecuting this case on behalf of the government. The Federal Bureau of Investigation, Pennsylvania Office of the Attorney General – Medicaid Fraud Control Unit, Internal Revenue Service – Criminal Investigation, U.S. Department of Health and Human Services – Office of Inspector General, and United States Postal Inspection Service conducted the investigation of the defendants.


SOURCE: news provided by JUSTICE.GOV on Tuesday, November 27, 2018.