Home Health & Hospice Week

The big fish in the Moriarty Consultants Medicaid fraud case in Pittsburgh have finally had their reckoning.

Reminder: Between January 2011 and April 2017, Moriarty Consultants Inc. (MCI), Activity Daily Living Services Inc. (ADL), and Coordination Care Inc. (CCI) collectively received more than $87 million in Medicaid payments based on claims submitted for home health services, the Department of Justice notes in a release. During that time, Arlinda 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 DOJ says.

Moriarty owned MCI, her sister Daynelle Dickens owned CCI, and their uncle Tony Brown was an employee of MCI. They admitted to fraudulent activities including fabricating timesheets, paying kickbacks to consumers in exchange for their participation in the scheme (including Brown’s son-in-law), submitting bulk claims for so-called “unused hours,” and forging documentation when audited, the Justice Department says.

After pleading guilty to fraud and other charges, Moriarty, Dickens, and Brown have agreed to pay restitution of $8.7 million, $1 million, and about $43,000, respectively, the DOJ says. They are scheduled for sentencing in September.

A total of 16 defendants were charged in connection with the scheme, and 15 have now pleaded guilty. The remaining defendant died, according to the DOJ.