Score:   1
Docket Number:   WD-PA  2:18-cr-00315
Case Name:   USA v. MORIARTY et al
  Press Releases:
PITTSBURGH, Pa. – Two residents of Pittsburgh, Pennsylvania, pleaded guilty in federal court yesterday to one count each of conspiracy to defraud the Pennsylvania Medicaid program and health care fraud, United States Attorney Scott W. Brady announced today.

Terra Dean, 46, and Larita Walls, 57, pleaded guilty in separate hearings before United States District Judge Cathy Bissoon.

During their plea hearings, Dean and Walls admitted that between 2011 and 2017 they were employees of Moriarty Consultants, Inc. (MCI), one of four related entities operating in the home health care industry. The other three entities were Activity Daily Living Services, Inc. (ADL), Coordination Care, Inc. (CCI), and Everyday People Staffing, Inc. (EPS). MCI, ADL, and CCI were approved under the Pennsylvania Medicaid program to offer certain services to qualifying Medicaid recipients ("consumers"), including personal assistance services (PAS), service coordination, and non-medical transportation, among other services. Between in and around January 2011 and in and around April 2017, MCI, ADL, and CCI, collectively, received more than $87,000,000 in Medicaid payments based on claims submitted for these services, with PAS payments accounting for more than $80,000,000 of the total amount.

During that time, Dean and Walls admitted that they participated in a wide-ranging conspiracy to defraud the Pennsylvania Medicaid program for the purpose of obtaining millions of dollars in illegal Medicaid payments through the submission of fraudulent claims for services that were never provided to the consumers identified on the claims, or for which there was insufficient or fabricated documentation to support the claims. As part of the conspiracy, Dean and Walls admitted that they fabricated timesheets to reflect the provision of in-home PAS care that, in fact, they never provided to the consumers identified on the timesheets. The defendants further admitted that they caused the submission of Medicaid claims in the name of "ghost" employees—including close relatives—for PAS care that was never provided to the consumers specified on Medicaid claims. Likewise, Dean and Walls admitted that they paid kickbacks to consumers in exchange for the consumer’s cooperation in the fraudulent billing scheme. In total, Dean and Walls each admitted causing losses to the Pennsylvania Medicaid program in excess of $150,000.

Judge Bissoon scheduled Dean’s and Walls’s sentencing hearings for 10:00 a.m. and 2:15 p.m. on May 19, 2020, respectively.

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. 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.

To date, a total of sixteen defendants have been charged in connection with this investigation. Dean and Walls are the tenth and eleventh defendants to enter guilty pleas. The remaining 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.

PITTSBURGH, Pa. – A resident of Pittsburgh, Pennsylvania, pleaded guilty in federal court yesterday to one count each of conspiracy to defraud the Pennsylvania Medicaid program and health care fraud, United States Attorney Scott W. Brady announced today.

Keith Scoggins, 54, pleaded guilty before United States District Judge Cathy Bissoon.

During his plea hearing, Scoggins admitted that between 2011 and 2017 he was an employee of Moriarty Consultants, Inc. (MCI), one of four related entities operating in the home health care industry. The other three entities were Activity Daily Living Services, Inc. (ADL), Coordination Care, Inc. (CCI), and Everyday People Staffing, Inc. (EPS). MCI, ADL, and CCI were approved under the Pennsylvania Medicaid program to offer certain services to qualifying Medicaid recipients ("consumers"), including personal assistance services (PAS), service coordination, and non-medical transportation, among other services. Between in and around January 2011 and in and around April 2017, MCI, ADL, and CCI, collectively, received more than $87,000,000 in Medicaid payments based on claims submitted for these services, with PAS payments accounting for more than $80,000,000 of the total amount.

During that time, Scoggins, who was employed in a supervisory position as PAS Director, admitted that he participated in a wide-ranging conspiracy to defraud the Pennsylvania Medicaid program for the purpose of obtaining millions of dollars in illegal Medicaid payments through the submission of fraudulent claims for services that were never provided to the consumers identified on the claims, or for which there was insufficient or fabricated documentation to support the claims. As part of the conspiracy, Scoggins admitted that he fabricated timesheets to reflect the provision of in-home PAS care that, in fact, he never provided to the consumer identified on the timesheets. Scoggins further admitted that he caused the submission of Medicaid claims in the name of a "ghost" employee—a close relative—for PAS care that was never provided to the consumer specified on the claims. Likewise, Scoggins admitted that he paid kickbacks to a consumer, totaling approximately $160 every two weeks, in exchange for the consumer’s cooperation in the fraudulent billing scheme. In total, Scoggins admitted causing losses to the Pennsylvania Medicaid program in excess of $100,000.

Judge Bissoon scheduled Scoggins’s sentencing for 2:15 p.m. on May 5, 2020.

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. 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 defendant.

To date, a total of sixteen defendants have been charged in connection with this investigation. Scoggins is the ninth defendant to enter a guilty plea. The remaining 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.

PITTSBURGH, Pa. – A resident of Fort Mill, South Carolina, pleaded guilty in federal court to one count each of conspiracy to defraud the Pennsylvania Medicaid program and health care fraud, United States Attorney Scott W. Brady announced today.

Tia Collins, 44, pleaded guilty before United States District Judge Cathy Bissoon.

During her plea hearing, Tia Collins admitted that between 2011 and 2017 she was affiliated with Moriarty Consultants, Inc. (MCI), Activity Daily Living Services, Inc. (ADL), and Everyday People Staffing, Inc. (EPS)—three related entities operating in the home health care industry. MCI, ADL, and a fourth company, Coordination Care, Inc. (CCI), were approved under the Pennsylvania Medicaid program to offer certain services to qualifying Medicaid recipients ("consumers"), including personal assistance services (PAS), service coordination, and non-medical transportation, among other services. Between in and around January 2011 and in and around April 2017, MCI, ADL, and CCI, collectively, received more than $87,000,000 in Medicaid payments based on claims submitted for these services, with PAS payments accounting for more than $80,000,000 of the total amount.

During that time, Collins admitted that she participated in a wide-ranging conspiracy to defraud the Pennsylvania Medicaid program for the purpose of obtaining millions of dollars in illegal Medicaid payments through the submission of fraudulent claims for services that were never provided to the consumers identified on the claims, or for which there was insufficient or fabricated documentation to support the claims. As part of the conspiracy, Collins admitted that she fabricated timesheets to reflect the provision of in-home PAS care that, in fact, she never provided to consumers. Collins also admitted that she caused the submission of Medicaid claims in the name of a "ghost" employee for PAS care that was never provided to the consumers specified on the claims. Collins also paid or caused other individuals to pay certain consumers cash kickbacks in exchange for the consumers’ participation in the fraudulent arrangement. Likewise, Collins admitted that she paid additional kickbacks to consumers out of the proceeds of fraudulent transportation reimbursements Collins caused Medicaid to disburse on behalf of the consumers. In total, Collins admitted causing losses to the Pennsylvania Medicaid program in excess of $150,000.

Judge Bissoon scheduled Street’s sentencing for 2:15 p.m. on April 9, 2020.

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. 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 defendant.

To date, a total of sixteen defendants have been charged in connection with this investigation. Collins is the eighth defendant to enter a guilty plea. The remaining 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.

PITTSBURGH, Pa. – A resident of Pittsburgh, Pennsylvania, pleaded guilty in federal court to one count each of conspiracy to defraud the Pennsylvania Medicaid program and health care fraud, United States Attorney Scott W. Brady announced today.

Tionne Street, 48, pleaded guilty before United States District Judge Cathy Bissoon on November 22, 2019.

During her plea hearing, Street admitted that she was an employee of Moriarty Consultants, Inc. (MCI), one of four related entities operating in the home health care industry.  The other three entities were Activity Daily Living Services, Inc. (ADL), Coordination Care, Inc. (CCI), and Everyday People Staffing, Inc. (EPS).  MCI, ADL, and CCI were approved under the Pennsylvania Medicaid program to offer certain services to qualifying Medicaid recipients (“consumers”), including personal assistance services (PAS), service coordination, and non-medical transportation, among other services.  Between in and around January 2011 and in and around April 2017, MCI, ADL, and CCI, collectively, received more than $87,000,000 in Medicaid payments based on claims submitted for these services, with PAS payments accounting for more than $80,000,000 of the total amount.

During that time, Street admitted that she participated in a wide-ranging conspiracy to defraud the Pennsylvania Medicaid program for the purpose of obtaining millions of dollars in illegal Medicaid payments through the submission of fraudulent claims for services that were never provided to the consumers identified on the claims, or for which there was insufficient or fabricated documentation to support the claims.  As part of the conspiracy, Street admitted that she fabricated timesheets to reflect the provision of in-home PAS care that, in fact, she never provided to consumers.  Some of the fabricated care occurred while Street was working for a different employer.  In total, Street admitted causing the submission of false timesheets for more than a half dozen consumers, resulting in fraudulent Medicaid reimbursements of approximately $70,000.

Judge Bissoon scheduled Street’s sentencing for 10 a.m. on March 17, 2020.

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.  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 defendant.

To date, a total of sixteen defendants have been charged in connection with this investigation.  Street is the seventh defendant to enter a guilty plea.  The remaining 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.

PITTSBURGH, Pa. – A resident of Pittsburgh, Pennsylvania, pleaded guilty in federal court to one count each of conspiracy to defraud the Pennsylvania Medicaid program and health care fraud, United States Attorney Scott W. Brady announced today.

Julie Wilson, 48, pleaded guilty before United States District Judge Cathy Bissoon.

During her plea hearing, Wilson admitted that, at various times between 2011 and 2017, she was an employee of Moriarty Consultants, Inc. (MCI) and Everyday People Staffing, Inc. (EPS), two related entities operating in the home health care industry. The other entities were Activity Daily Living Services, Inc. (ADL) and Coordination Care, Inc. (CCI). MCI, ADL, and CCI were approved under the Pennsylvania Medicaid program to offer certain services to qualifying Medicaid recipients ("consumers"), including personal assistance services (PAS), service coordination, and non-medical transportation, among other services. Wilson admitted that she was responsible for claims processing and billing matters related to Pennsylvania Medicaid. Between in and around January 2011 and in and around April 2017, MCI, ADL, and CCI, collectively, received more than $87,000,000 in Medicaid payments based on claims submitted for these services, with PAS payments accounting for more than $80,000,000 of the total amount.

During that time, Wilson admitted that she participated in a wide-ranging conspiracy to defraud the Pennsylvania Medicaid program for the purpose of obtaining millions of dollars in illegal Medicaid payments through the submission of fraudulent claims for services that were never provided to the consumers identified on the claims, or for which there was insufficient or fabricated documentation to support the claims. Among others, Wilson admitted that she conspired with Arlinda Moriarty, the owner of MCI, ADL, and EPS; Daynelle Dickens, the owner of CCI and Arlinda Moriarty’s sister; various office workers at the companies, including Tamika Adams, Tony Brown, Terra Dean, Larita Walls, Keith Scoggins, and Tia Collins; and attendants at MCI, including Tionne Street and Luis Columbie-Abrew.

As part of the conspiracy, Wilson admitted that she and various co-conspirators fabricated timesheets to reflect the provision of in-home PAS care they provided to consumers, when, in fact, no such care ever occurred. Wilson further admitted that, at Arlinda Moriarty’s direction, she collected information about consumers who had "unused" PAS care hours—that is, hours of authorized PAS care that had not been performed and, as a result, had not been billed to Pennsylvania Medicaid. In response, Wilson would provide lists of such consumers and their "unused" hours to Arlinda Moriarty and Daynelle Dickens. Moriarty, in turn, would direct Wilson to submit false claims, in bulk, for some or all of the "unused" hours—without the relevant consumers’ knowledge or consent. Wilson further admitted that she would then send Moriarty a list of the "unused" hours Wilson had billed and that required the creation of back-dated timesheets to document the purported care. Wilson further admitted that she caused Medicaid billings for purported in-home care of a consumer while the consumer was in the hospital, and that she obtained signature stamps for certain consumers that were used execute falsified timesheets in the consumers’ names.

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. 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 defendant.

To date, a total of 16 defendants have been charged in connection with this investigation. Wilson is the sixth defendant to enter a guilty plea. The remaining 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.

PITTSBURGH, Pa. – A resident of Atlanta, Georgia, pleaded guilty in federal court to one count each of conspiracy to defraud the Pennsylvania Medicaid program, health care fraud, and aggravated identity theft, United States Attorney Scott W. Brady announced today.

Luis Columbie-Abrew, 33, pleaded guilty before United States District Judge Cathy Bissoon.

During his plea hearing, Columbie-Abrew admitted that he was an employee of Moriarty Consultants, Inc. (MCI), one of four related entities operating in the home health care industry. The other three entities were Activity Daily Living Services, Inc. (ADL), Coordination Care, Inc. (CCI), and Everyday People Staffing, Inc. (EPS). MCI, ADL, and CCI were approved under the Pennsylvania Medicaid program to offer certain services to qualifying Medicaid recipients ("consumers"), including personal assistance services (PAS), service coordination, and non-medical transportation, among other services. Between in and around January 2011 and in and around April 2017, MCI, ADL, and CCI, collectively, received more than $87,000,000 in Medicaid payments based on claims submitted for these services, with PAS payments accounting for more than $80,000,000 of the total amount.

During that time, Columbie-Abrew admitted that he participated in a wide-ranging conspiracy to defraud the Pennsylvania Medicaid program for the purpose of obtaining millions of dollars in illegal Medicaid payments through the submission of fraudulent claims for services that were never provided to the consumers identified on the claims, or for which there was insufficient or fabricated documentation to support the claims. The Court was further advised that Columbie-Abrew conspired with, among others, Arlinda Moriarty, the owner of MCI, ADL, and EPS; Daynelle Dickens, the owner of CCI and Arlinda Moriarty’s sister; various office workers at the companies, including Julie Wilson, Tamika Adams, Tony Brown, Terra Dean, Larita Walls, Keith Scoggins, and Tia Collins; attendants at MCI, including Tionne Street; and Terry Adams, a consumer.

As part of the conspiracy, Columbie-Abrew admitted that co-conspirators fabricated timesheets to reflect the provision of in-home PAS care they provided to consumers but that, in fact, never occurred. In addition, at Arlinda Moriarty’s direction, certain co-conspirators, including Columbie-Abrew, stopped using their own names as the attendant on timesheets and instead used the names of "ghost" attendants, some of whom permitted their names to be used in exchange for a kickback of resulting fraudulent salary payments.

Columbie-Abrew also admitted that he and other co-conspirators submitted false timesheets for PAS care they never provided during times when they were actually working at other jobs or living out of the area. Specifically, Columbie-Abrew admitted that during the conspiracy—from approximately early 2011 through approximately mid 2017—he caused the submission of false timesheets for care of two consumers who resided in Pennsylvania, despite the fact that Columbie- Abrew lived permanently in Georgia. In total PA Medicaid reimbursed Moriarty-related entities approximately $315,000 for purported care of these two consumers.

Columbie-Abrew further admitted that Arlinda Moriarty directed co-conspirators to bill the maximum allowable PAS and service coordination hours for consumers to maximize profits and to ensure that the state did not require MCI, ADL, and CCI to forfeit underutilized consumer hours. Many consumers had no knowledge that their personally identifiable information was being used to bill Medicaid for benefits that the consumers had not exhausted. Moreover, the Court was further advised during the plea hearing that, as part of the conspiracy, Arlinda Moriarty directed employees to fabricate documentation during the course of state audits.

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 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 defendant.

To date, a total of 16 defendants have been charged in connection with this investigation. Columbie-Abrew is the fifth defendant to enter a guilty plea. The remaining 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.

PITTSBURGH, Pa. – Two residents of Pittsburgh, Pennsylvania, were sentenced in federal court for conspiracy to defraud the Pennsylvania Medicaid program, United States Attorney Scott W. Brady announced today.

United States District Judge Cathy Bissoon sentenced Autumn Brown, 31, and Brenda Lowry Horton, 48, to five years of probation, including six months of home detention, for their roles in a years-long conspiracy. Brown and Lowry Horton were also ordered to pay restitution to the Pennsylvania Medicaid program in the amount of $68,917.80 and $67,107.32, respectively.

During their respective plea hearings in December 2018, the defendants admitted that they were employees of one or more related entities operating in the home health care industry—Moriarty Consultants, Inc. (MCI), Activity Daily Living Services, Inc. (ADL), and Everyday People Staffing, Inc. (EPS). Each of these entities was owned or controlled by Arlinda Moriarty. MCI and ADL were approved under the Pennsylvania Medicaid program to offer certain services to qualifying Medicaid recipients ("consumers"), including personal assistance services (PAS), service coordination, and non-medical transportation, among other services. Between in and around January 2011 and in and around April 2017, MCI, ADL, and another related entity (Coordination Care, Inc.), collectively, received more than $87,000,000 in Medicaid payments based on claims submitted for these services, with PAS payments accounting for more than $80,000,000 of the total amount.

During that time, the defendants admitted that they participated in a wide-ranging conspiracy to defraud the Pennsylvania Medicaid program for the purpose of obtaining illegal Medicaid payments through the submission of fraudulent claims for services that were never provided to the consumers identified on the claims or for which there was insufficient or fabricated documentation to support the claims. The Court was further advised that the defendants conspired with, among others, various office workers at the companies, including Tiffhany Covington and Tia Collins. As part of the conspiracy, the defendants admitted that they fabricated timesheets to reflect the provision of in-home PAS care they provided to consumers but that, in fact, never occurred. In addition, at Arlinda Moriarty’s direction, certain co-conspirators, including Lowry Horton, stopped using their own names as the attendant on timesheets and instead used the names of "ghost" attendants, some of whom permitted their names to be used in exchange for a kickback of resulting fraudulent salary payments. Brown admitted that she allowed her name to be used in this manner and that she received a portion of the fraudulent proceeds from Ms. Covington. Lowry Horton further admitted that, as part of the conspiracy, she and others paid kickbacks to consumers in exchange for the consumers’ agreement to sign—or allow their names to be forged on—false timesheets.

To date, 16 people have been charged with offenses related to the conspiracy.

Assistant United States Attorney 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.

PITTSBURGH, Pa. – Three residents of Pittsburgh, Pennsylvania, pleaded guilty in federal court this week to conspiracy to defraud the Pennsylvania Medicaid program, United States Attorney Scott W. Brady announced today.

Travis Moriarty, 37, Tiffhany Covington, 41, and Brenda Lowry Horton, 48, all of Pittsburgh, Pennsylvania, pleaded guilty to one count in separate hearings before United States District Judge Cathy Bissoon.

During their plea hearings, each defendant admitted that they were employees of one or more of four related entities operating in the home health care industry—Moriarty Consultants, Inc. (MCI), Activity Daily Living Services, Inc. (ADL), Coordination Care, Inc. (CCI), and Everyday People Staffing, Inc. (EPS). MCI, ADL, and CCI were approved under the Pennsylvania Medicaid program to offer certain services to qualifying Medicaid recipients ("consumers"), including personal assistance services (PAS), service coordination, and non-medical transportation, among other services. Between in and around January 2011 and in and around April 2017, MCI, ADL, and CCI, collectively, received more than $87,000,000 in Medicaid payments based on claims submitted for these services, with PAS payments accounting for more than $80,000,000 of the total amount.

During that time, the defendants admitted that they participated in a wide-ranging conspiracy to defraud the Pennsylvania Medicaid program for the purpose of obtaining millions of dollars in illegal Medicaid payments through the submission of fraudulent claims for services that were never provided to the consumers identified on the claims or for which there was insufficient or fabricated documentation to support the claims. The Court was further advised that the defendants conspired with, among others, Arlinda Moriarty, the owner of MCI, ADL, and EPS; Daynelle Dickens, the owner of CCI and Arlinda Moriarty’s sister; various office workers at the companies, including Julie Wilson, Tamika Adams, Tony Brown, Terra Dean, Larita Walls, Keith Scoggins, and Tia Collins; attendants at MCI, including Tionne Street, Autumn Brown, and Luis Columbie-Abrew; and Terry Adams, a consumer.

As part of the conspiracy, the defendants admitted that co-conspirators fabricated timesheets to reflect the provision of in-home PAS care they provided to consumers but that, in fact, never occurred. In addition, at Arlinda Moriarty’s direction, certain co-conspirators stopped using their own names as the attendant on timesheets and instead used the names of "ghost" attendants, some of whom permitted their names to be used in exchange for a kickback of resulting fraudulent salary payments. The defendants also admitted that certain co-conspirators submitted false timesheets for PAS care they never provided during times when they were actually working at other jobs or living out of the area. In some cases, as the defendants acknowledged, Medicaid claims were submitted for PAS care that purportedly occurred while consumers were hospitalized, incarcerated, or deceased, and in other instances, co-conspirators paid kickbacks to consumers in exchange for the consumers’ agreement to participate in the submission of fraudulent timesheets in support of Medicaid claims.

The defendants also admitted that Arlinda Moriarty directed co-conspirators to bill the maximum allowable PAS and service coordination hours for consumers to maximize profits and to ensure that the state did not require MCI, ADL, and CCI to forfeit underutilized consumer hours. Many consumers had no knowledge that their personally identifiable information was being used to bill Medicaid for benefits that the consumers had not exhausted. Moreover, the Court was further advised during the plea hearings that, as part of the conspiracy, Arlinda Moriarty directed employees to fabricate documentation during the course of state audits.

The defendants each face a maximum total sentence of not more than 10 years in prison, a fine of $250,000, or both. 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.

Autumn Brown was charged by Criminal Information on October 18, 2018, and a plea hearing is scheduled for December 14, 2018.

On November 26, 2018, a federal grand jury indicted Arlinda Moriarty, Dickens, Wilson, Tamika Adams, Tony Brown, Terry Adams, Collins, Dean, Walls, Scoggins, Street, and Columbie- Abrew for their roles in the conspiracy. 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.

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 Tia Collins, 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.

 

Docket (0 Docs):   https://docs.google.com/spreadsheets/d/1IrGETUqQKLpcS0cC_nZ6Ye2IzXbdNeIw-Mu6mw8vCvY
  Last Updated: 2024-03-08 02:20:33 UTC
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Format: A18

Description: A concatenation of district, office, docket number, case type, and reopen sequence number
Format: A15

Description: The status of the defendant as assigned by the AOUSC
Format: A2

Description: A code indicating the fugitive status of a defendant
Format: A1

Description: The date upon which a defendant became a fugitive
Format: YYYYMMDD

Description: The date upon which a fugitive defendant was taken into custody
Format: YYYYMMDD

Description: The date when a case was first docketed in the district court
Format: YYYYMMDD

Description: The date upon which proceedings in a case commenced on charges pending in the district court where the defendant appeared, or the date of the defendant’s felony-waiver of indictment
Format: YYYYMMDD

Description: A code used to identify the nature of the proceeding
Format: N2

Description: The date when a defendant first appeared before a judicial officer in the district court where a charge was pending
Format: YYYYMMDD

Description: A code indicating the event by which a defendant appeared before a judicial officer in the district court where a charge was pending
Format: A2

Description: A code indicating the type of legal counsel assigned to a defendant
Format: N2

Description: The title and section of the U.S. Code applicable to the offense committed which carried the highest severity
Format: A20

Description: A code indicating the level of offense associated with FTITLE1
Format: N2

Description: The four digit AO offense code associated with FTITLE1
Format: A4

Description: The four digit D2 offense code associated with FTITLE1
Format: A4

Description: A code indicating the severity associated with FTITLE1
Format: A3

Description: The title and section of the U.S. Code applicable to the offense committed which carried the second highest severity
Format: A20

Description: A code indicating the level of offense associated with FTITLE2
Format: N2

Description: The four digit AO offense code associated with FTITLE2
Format: A4

Description: The four digit D2 offense code associated with FTITLE2
Format: A4

Description: A code indicating the severity associated with FTITLE2
Format: A3

Description: The title and section of the U.S. Code applicable to the offense committed which carried the third highest severity
Format: A20

Description: A code indicating the level of offense associated with FTITLE3
Format: N2

Description: The four digit AO offense code associated with FTITLE3
Format: A4

Description: The four digit D2 offense code associated with FTITLE3
Format: A4

Description: A code indicating the severity associated with FTITLE3
Format: A3

Description: The title and section of the U.S. Code applicable to the offense committed which carried the fourth highest severity
Format: A20

Description: A code indicating the level of offense associated with FTITLE4
Format: N2

Description: The four digit AO offense code associated with FTITLE4
Format: A4

Description: The four digit D2 offense code associated with FTITLE4
Format: A4

Description: A code indicating the severity associated with FTITLE4
Format: A3

Description: The FIPS code used to indicate the county or parish where an offense was committed
Format: A5

Description: The date of the last action taken on the record
Format: YYYYMMDD

Description: The date upon which judicial proceedings before the court concluded
Format: YYYYMMDD

Description: The date upon which the final sentence is recorded on the docket
Format: YYYYMMDD

Description: The date upon which the case was closed
Format: YYYYMMDD

Description: The total fine imposed at sentencing for all offenses of which the defendant was convicted and a fine was imposed
Format: N8

Description: A count of defendants filed including inter-district transfers
Format: N1

Description: A count of defendants filed excluding inter-district transfers
Format: N1

Description: A count of original proceedings commenced
Format: N1

Description: A count of defendants filed whose proceedings commenced by reopen, remand, appeal, or retrial
Format: N1

Description: A count of defendants terminated including interdistrict transfers
Format: N1

Description: A count of defendants terminated excluding interdistrict transfers
Format: N1

Description: A count of original proceedings terminated
Format: N1

Description: A count of defendants terminated whose proceedings commenced by reopen, remand, appeal, or retrial
Format: N1

Description: A count of defendants pending as of the last day of the period including long term fugitives
Format: N1

Description: A count of defendants pending as of the last day of the period excluding long term fugitives
Format: N1

Description: The source from which the data were loaded into the AOUSC’s NewSTATS database
Format: A10

Description: A sequential number indicating the iteration of the defendant record
Format: N2

Description: The date the record was loaded into the AOUSC’s NewSTATS database
Format: YYYYMMDD

Description: Statistical year ID label on data file obtained from the AOUSC which represents termination year
Format: YYYY

Data imported from FJC Integrated Database
F U C K I N G P E D O S R E E E E E E E E E E E E E E E E E E E E