Con Costs

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Man giving bribe to a doctor

One of the most common methods of healthcare fraud comes from healthcare workers billing insurance programs for services that are never delivered. What people may not realize is just how stiff the penalty can be in these cases.

One of the latest cases of in-home healthcare fraud comes from Pittsburgh where a 44-year-old woman, who is now a resident of Fort Mill, S.C., pleaded guilty in federal court to one count each of conspiracy to defraud the Pennsylvania Medicaid program and healthcare fraud.

The woman admitted that between 2011 and 2017 she was affiliated with three, related Pittsburgh-area home health businesses – Moriarty Consultants, Activity Daily Living Services, and Everyday People Staffing. The businesses were approved to offer services billable to the state Medicaid program, including personal assistance, service coordination and nonmedical transportation. The three companies received more than $87,000 in payments from Medicaid over six years.

As part of her plea, the woman admitted to causing more than $150,000 in total losses to the Pennsylvania Medicaid program by filing fraudulent claims. (She also confessed to a few more things.) She fabricated timesheets for services to patients who never received them, submitted claims in the name of a “ghost” employee, and paid kickbacks to others to take part in the conspiracy. 

Today’s fraudster from South Carolina faces ten years in prison on each of the two charges and fines up to $250,000. She is scheduled to be sentenced in April for committing Medicaid Fraud. (Whatever happiness the money brought her doesn’t seem worth the penalty).

Today’s Fraud of the Day is based on a U.S. Department of Justice press release, “South Carolina Resident Pleads Guilty to Health Care Fraud,” issued Dec. 18, 2019.

PITTSBURGH, Pa. – A resident of Fort Mill, South Carolina, pleaded guilty in federal court to one count each of conspiracy to defraud the Pennsylvania Medicaid program and health care fraud, United States Attorney Scott W. Brady announced today.

Tia Collins, 44, pleaded guilty before United States District Judge Cathy Bissoon.

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Larry Benson, Senior Director of Strategic Alliances, LexisNexis Risk Solutions - Government

Larry Benson is responsible for developing strategic partnerships and solutions for the government vertical. His expertise focuses on how government programs are defrauded by criminal groups, and the approaches necessary to prevent them from succeeding.

Mr. Benson has 30 years of experience in sales and business development. Before joining LexisNexis® Risk Solutions, he spent 12 years founding and managing two software technology startups. During the 1990s he spent 10 years as a Regional Director helping to grow a New England-based technology company from 300 employees to 7,000. He started his career with Martin Marietta Aerospace working on laser guided weapons and day/night vision systems.

A sought-after speaker and accomplished writer, Mr. Benson is the principal author of “Fraud of the Day,” a website dedicated to educating government officials about how criminals are defrauding government programs. He has co-authored WTF? Where’s the Fraud? How to Unmask and Stop Identity Fraud’s Drain on Our Government, and Data Personified, How Fraud is Changing the Meaning of Identity.

Benson holds a Bachelor of Science in Physics from Albright College, and earned two graduate degrees – a Master of Business Administration from Florida Institute of Technology, and a Master of Science in Engineering from Lehigh University.