Three Remaining Defendants Plead Guilty for Their Roles in Extensive Health Care Fraud Conspiracy to Defraud Medicaid Home Care Program
A Total of Fifteen Defendants Have Pleaded Guilty in Connection with the Conspiracy
PITTSBURGH, Pa. – Three residents of the Pittsburgh area pleaded guilty in federal court today for their roles in defrauding the Pennsylvania Medicaid program, United States Attorney Cindy K. Chung announced today.
Arlinda Moriarty, 53, of Cranberry, Pennsylvania, her sister Daynelle Dickens, 47, of Pittsburgh, and their uncle Tony Brown, 64, also of Pittsburgh, pleaded guilty to one count each of conspiracy to commit health care fraud and health care fraud before United States District Judge Cathy Bissoon. Moriarty also pleaded guilty to one count of engaging in a scheme to conceal material facts in a health care matter and one count of aggravated identity theft.
According to admissions made in connection with the defendants’ guilty pleas, between January 2011 and April 2017, Moriarty, Dickens, and Brown were associated with four related entities controlled by Moriarty—Moriarty Consultants, Inc. (MCI), Activity Daily Living Services, Inc. (ADL), Everyday People Staffing, Inc. (EPS), and Coordination Care, Inc. (CCI). Dickens owned CCI, and Brown was an employee of MCI. 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. EPS nominally performed back-office functions for MCI, ADL, and CCI.
Between January 2011 and April 2017, MCI, ADL, and CCI, collectively, received more than $87,000,000 in Medicaid payments based on claims submitted for home health services, with PAS payments accounting for more than $80,000,000 of the total amount. During that time, Moriarty admitted orchestrating a wide-ranging conspiracy to defraud Medicaid 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 defendants admitted that the conspiracy and fraud scheme were carried out in a variety of ways. For example, co-conspirators fabricated timesheets to reflect the provision of in-home PAS care that, in fact, they never provided to the consumers identified on timesheets. Members of the conspiracy also paid kickbacks to consumers in exchange for their participation in the scheme. Indeed, Brown admitted paying kickbacks to his then-son-in-law in connection with the submission of fraudulent Medicaid claims stating that Brown had provided in-home care for the son-in-law, when, in fact, he had not. As part of the conspiracy, co-conspirators also caused the submission of
Medicaid claims in the name of “ghost” employees for PAS care that never occurred.
Moriarty and Dickens also admitted causing the periodic bulk submission of fraudulent Medicaid claims for so-called “unused” hours—i.e., excess hours of care that consumers had not needed and therefore should not have been billed. Finally, Moriarty admitted that during the course of audits of MCI, ADL, and CCI, she directed the fabrication of various documents for submission to state authorities in an effort to conceal the Medicaid fraud scheme. Among other things, co-conspirators fabricated PAS timesheets, criminal history checks for attendants, child-abuse clearance forms for attendants, and certain consumer affidavits to ensure that files requested as part of the audits appeared complete. During the conspiracy, Moriarty and Dickens received payments from the Moriarty-related companies totaling approximately $1,660,000 and $1,071,000, respectively.
In connection with their guilty pleas, Moriarty, Dickens, and Brown have agreed to pay restitution of $8,700,000, $1,000,000, and $43,113.02, respectively.
A total of 16 defendants were charged in connection with the health care fraud conspiracy and scheme, and 15 have now pleaded guilty. The remaining defendant died during the pendency of the case.
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 concealment of material facts in relation to a health care matter charge carries a maximum total sentence of not more than five years in prison, a fine of $250,000, or both. The aggravated identity theft charge carries 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 defendants.
Judge Bissoon scheduled sentencing hearings for Moriarty, Dickens, and Brown on September 28, 2022.
Assistant United States Attorney 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.