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Man giving bribe to a doctor

One of the most common methods of healthcare fraud comes from healthcare workers billing insurance programs for services that are never delivered. What people may not realize is just how stiff the penalty can be in these cases.

One of the latest cases of in-home healthcare fraud comes from Pittsburgh where a 44-year-old woman, who is now a resident of Fort Mill, S.C., pleaded guilty in federal court to one count each of conspiracy to defraud the Pennsylvania Medicaid program and healthcare fraud.

The woman admitted that between 2011 and 2017 she was affiliated with three, related Pittsburgh-area home health businesses – Moriarty Consultants, Activity Daily Living Services, and Everyday People Staffing. The businesses were approved to offer services billable to the state Medicaid program, including personal assistance, service coordination and nonmedical transportation. The three companies received more than $87,000 in payments from Medicaid over six years.

As part of her plea, the woman admitted to causing more than $150,000 in total losses to the Pennsylvania Medicaid program by filing fraudulent claims. (She also confessed to a few more things.) She fabricated timesheets for services to patients who never received them, submitted claims in the name of a “ghost” employee, and paid kickbacks to others to take part in the conspiracy. 

Today’s fraudster from South Carolina faces ten years in prison on each of the two charges and fines up to $250,000. She is scheduled to be sentenced in April for committing Medicaid Fraud. (Whatever happiness the money brought her doesn’t seem worth the penalty).

Today’s Fraud of the Day is based on a U.S. Department of Justice press release, “South Carolina Resident Pleads Guilty to Health Care Fraud,” issued Dec. 18, 2019.

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.

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Larry Benson
Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.