Two Defendants Sentenced in Multi-Million Dollar Health Care Fraud Conspiracy
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.
In connection with their guilty pleas, the defendants admitted that between 2011 and 2017 they were employees 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), 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, Walls and Street admitted that they 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. As part of the conspiracy, Walls and Street admitted that they fabricated timesheets to reflect the provision of in-home PAS care that, in fact, they never provided to the consumers identified on the timesheets. Some of the fabricated care occurred while Street was, in fact, working for a different employer. Walls further admitted that she caused the submission of Medicaid claims in the name of "ghost" employees—close relatives—for PAS care that did not occur. Likewise, Walls admitted that she paid kickbacks to a consumer in exchange for the consumer’s participation in the fraudulent billing scheme. In total, Walls and Street admitted causing losses to the Pennsylvania Medicaid program in excess of $180,000 and $70,000, respectively.
To date, twelve defendants have pleaded guilty for their roles in the conspiracy.
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.