Harrisburg Health Care Provider Charged Federally With Medicaid Fraud

     The United States Attorney’s Office for the Middle District of Pennsylvania announced today that a Harrisburg-area health care services provider was charged on June 18th by a federal grand jury with making false statements relating to health care matters, money laundering, and identity theft.

     According to U.S. Attorney Peter Smith, on Wednesday, a federal grand jury in Harrisburg returned a 34-count indictment charging that between 2010 and 2014 Rose Umana, 47, Mechanicsburg, the owner and operator of Vision Healthcare Services, Inc., 4113 Linglestown Road, Harrisburg, created false identification documents and fictitious occupational licenses for workers not licensed at the level represented on the license.  Umana then allegedly submitted bills to Medicaid for medical services supposedly provided by the workers, billed Medicaid for services provided by someone other than the person claimed to be the provider, and billed Medicaid for services not provided or provided by someone not qualified to provide the service.

     In addition, the Grand Jury charged that Umana conducted at least 32 monetary transactions totaling $673,733 with proceeds derived from the criminal activity.  The indictment also alleges that funds totaling approximately $307,000 in three bank accounts held by Umana are forfeitable to the government.

     Umana appeared today before U.S. Magistrate Judge Susan E. Schwab.  She was ordered released and to be under electronic monitoring.  Trial is scheduled for August 4, 2014 before Senior U.S. District Court Judge Sylvia H. Rambo. 

     Medicaid is the joint federal–state program that provides health care and nursing home coverage to low asset/income individuals.  Medicaid in Pennsylvania is administered by the Department of Public Welfare.  Vision Healthcare Services, Inc., is a medical staffing company and home care services provider servicing Dauphin, Cumberland, Perry and York Counties and has been enrolled under Medicaid since 2006.

     “Those who steal from government programs such as Medicaid are stealing from all of us,” said Attorney General Kathleen G. Kane. “They will be held accountable.”

     “We trust that Medicaid Home Care companies will do the right things; bill for services that they actually provide and use properly trained professionals to deliver needed care”  said Nick DiGiulio, Special Agent in Charge for the Inspector General’s Office of the United States Department of Health and Human Services in Philadelphia. “We will continue to work energetically with our partners to investigate those that are accused of stealing health care dollars and mistreating Medicaid recipients.”

     This case is the result of a cooperative investigation by the Office of Inspector General, U.S. Department of Health and Human Services; Internal Revenue Service Criminal Investigations; and the Medicaid Fraud Control Section of the Pennsylvania Office of Attorney General.  Special Assistant U.S. Attorney Heather Albright of the Pennsylvania Attorney General’s Office, and Assistant U.S. Attorney Christy H. Fawcett are assigned to the case.         

     False statements relating to health care matters carries a maximum term of imprisonment of five years, the money laundering offense is punishable by up to 10 years’ imprisonment, and identity theft carries a two-year mandatory minimum sentence that must be served consecutively to any other sentence.

     Indictments and Criminal Informations are only allegations. All persons charged are presumed to be innocent unless and until found guilty in court.

     A sentence following a finding of guilty is imposed by the Judge after consideration of the applicable federal sentencing statutes and the Federal Sentencing Guidelines.

     Under the Federal Sentencing Guidelines, the Judge is also required to consider and weigh a number of factors, including the nature, circumstances and seriousness of the offense; the history and characteristics of the defendant; and the need to punish the defendant, protect the public and provide for the defendant’s educational, vocational and medical needs. For these reasons, the statutory maximum penalty for the offense is not an accurate indicator of the potential sentence for a specific defendant.