“Ghost” Employee; Real Scam

Happy young woman and her cute son looking at doctor and listening to his recommendations

A Pennsylvania Personal Assistance Services director pleaded guilty to participating in a massive Medicaid fraud scheme. His plea included one count of conspiracy to defraud the Pennsylvania Medicaid program and one count of healthcare fraud.

Keith Scroggins, who worked for Moriarty Consultants, Inc., submitted fraudulent claims for services to the Pennsylvania Medicaid program. Services were never provided to the Medicaid recipients identified on the claims or claims were submitted with insufficient or fabricated documentation.

Scroggins created fraudulent timesheets, and even identified a close relative as a “ghost” employee of his company, billing phony claims under his name. He also paid kickbacks to a Medicaid recipient in exchange for cooperation.

Scroggins cost the Pennsylvania Medicaid program (and taxpayers) more than $100,000. With sentencing scheduled in May 2020, he could face up to 10 years in prison, a fine of $250,000, or both for his Medicaid fraud scheme. Scroggins’ activities were part of a massive conspiracy, with 16 defendants charged, and nine pleading guilty to date. (Looks like he’ll have plenty of friends to keep him company if he goes to prison.)

Today’s Fraud of the Day comes from a news release from the United States Attorney’s Office, Western District of Pennsylvania, “Pittsburgh Resident Pleads Guilty to Conspiracy and Health Fraud,” published Jan. 14, 2020.

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

Keith Scoggins, 54, pleaded guilty before United States District Judge Cathy Bissoon.

Previous articleVisa Switcheroo
Next articleDialing for Medicare Dollars

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.