Fraud Consultants Inc.

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Photo shows weekly salary on pay slip against US dollars in the background. Photo taken 04/02/16 in UK.

People tend to enjoy their work more when they are close with their co-workers. Two Pennsylvania women have reinforced their close working relationship by becoming fraudsters and co-conspirators who were recently convicted for Medicaid fraud. (They got each other into a lot of trouble, that’s for sure.)

Pittsburgh residents Larita Walls and Tionne Street admitted to being involved in a conspiracy to defraud Medicaid over the course of six years. They were charged and sentenced for conspiracy to defraud the Pennsylvania Medicaid program and health care fraud.

Between 2011 and 2017 Walls and Street were employed by Moriarty Consultants, Inc., (Was this case solved by Sherlock Holmes?) one of the health care companies involved in an elaborate scheme to fraudulently bill Medicaid for services never provided. The other home health companies involved in the scheme included Activity Daily Living Services, Inc. and Everyday People Staffing, Inc.

These home health companies were approved by the Pennsylvania Medicaid program to offer services to Medicaid beneficiaries. Services included non-medical transportation, personal assistance services, and other medical related services. Unfortunately, the companies abused their position by submitting fraudulent reimbursement claims.

Walls and Street fabricated timesheets from January 2011 to April 2017 to incorporate at-home personal assistance services they never provided. This fraudulent behavior also occurred at Activity Daily Living Services, Inc. and Everyday People Staffing, Inc.

The bogus timesheets listed fictitious employees and beneficiaries. Walls also paid kickbacks to beneficiaries who caught on to the fraudulent Medicaid billing scam in exchange for not being reported. (Walls thought she could sweep the company’s illicit activities under the rug.)

Walls is responsible for $180,000 of fraudulent claims, while Street is responsible for $70,000 of Medicaid’s losses. Together the health care companies received more than $87 million in Medicaid payments based on the padded billings. (People are capable of doing just about anything for money, especially when it will make them a multi-millionaire.)

Walls was sentenced to five years of probation with twelve months of home detention for committing Medicaid fraud. Street was sentenced to three years of probation, which includes six months of home detention. (Home detention doesn’t sound any different from what the rest of the country is doing during the current pandemic. They got off easy.)

Walls and Street were also ordered to pay restitution to the Pennsylvania Medicaid program in the amounts of $56,738.28 and $31,181.61, respectively. Twelve other defendants have pleaded guilty for their roles in the conspiracy.

Today’s Fraud of the Day comes from a Department of Justice press release, “Two Defendants Sentenced in Multi-Million Dollar Health Care Fraud Conspiracy,” dated June 25, 2020.

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

On June 24, 2020, United States District Judge Cathy Bissoon sentenced Larita Walls, 57, to five years of probation, including twelve months of home detention, and Tionne Street, 48, to three years of probation, including six months of home detention, for their roles in a years-long conspiracy. Walls and Street were also ordered to pay restitution to the Pennsylvania Medicaid program in the amounts of $56,738.28 and $31,181.61, respectively.

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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.