South Carolina Resident Sentenced in Multi-Million Dollar Health Care Fraud Conspiracy
PITTSBURGH, Pa. – A resident of Fort Mill, South Carolina, was sentenced in federal court for conspiracy to defraud the Pennsylvania Medicaid program and health care fraud, Acting United States Attorney Stephen R. Kaufman announced today.
United States District Judge Cathy Bissoon sentenced Tia Collins, 45, to four years’ probation, including six months of home detention for her role in the years-long conspiracy. Collins was also ordered to pay restitution to the Pennsylvania Medicaid program in the amount of $97,907.68.
During her plea hearing, 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 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.
To date, a total of sixteen defendants have been charged in connection with this investigation, twelve of whom have pleaded guilty. 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 defendant.