Georgia Resident Pleads Guilty to Conspiracy, Health Care Fraud and Aggravated Identity Theft
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.