Home Health & Hospice Week

Another home health employee has been sentenced in the ongoing Moriarty Consultants Medicaid fraud case in Pittsburgh.

Federal and state investigators raided the Moriarty offices in 2017 and have indicted 16 people on Medicaid fraud charges thus far (see HCW by AAPC, Vol. XXVI, No. 18). The case involves Moriarty and three other Medicaid HHAs, Activity Daily Living Services Inc., Coordination Care Inc., and Everyday People Staffing Inc.

In the latest sentencing, federal judge Cathy Bissoon sentenced Tamika Adams to nearly five-and-a-half years of imprisonment, followed by two years of supervised release, and $445,131 in restitution, according to a DOJ release. Adams admitted to fabricating time sheets saying she worked 80 hours per week while she functioned as ADL’s president; concealing disqualifying circumstances of her client; paying kickbacks to her then-spouse and father for participating in the scheme; stealing a friend’s information to submit false claims on her behalf; and forging a variety of documents relating to the scheme.

So far, 12 of the defendants have pleaded guilty in the case, the DOJ says.

Other Medicaid home care fraud cases nationwide include:

In Illinois: An administrative assistant to home health agency owners has received a nearly six-year prison term and was ordered to repay $6.3 million after a federal jury found her guilty of fraud in February 2020 (see HCW by AAPC, Vol. XXIX, No. 7). Angelita Newton worked for Care Specialists, a Chicago HHA owned by Ferdinand Echavia and later his wife, Ma Luisa Echavia, the DOJ notes in a release. Prosecutors showed at trial that about 90 percent of Care Specialists’ patients were not homebound and did not qualify for home care. “Further, many patients received cash bribes to receive home health ‘visits,’ some of which were performed in the visiting nurse’s car,” the DOJ adds. Newton falsified patient visit records used to support claims.

In Massachusetts: Medicaid HHA Independent at Home in Brockton and its owners, Loretta Ihedioha and Corona Robinson, will pay $1.2 million to settle charges that it billed the state for home health services that had not been authorized by a physician and for services it did not provide, the office of Attorney General Maura Healey says in a release. Independent also agreed to a three-year compliance program. “This company’s years of false billing has taken away state resources from the people who need it most,” says Healey in the release. “We will continue our work to hold bad actors in the home health industry accountable for fraudulent behavior.” Since 2016, the AG’s office has prosecuted three HHAs and their owners and settled civilly with 10 agencies, returning more than $42 million to MassHealth, it says. An HHS OIG tip sparked the investi­gation.

In Washington, D.C.: A licensed attorney has pleaded guilty to Medicaid Personal Care Services fraud to the tune of $100,000. Between 2016 and 2018 when she was in law school and preparing for the bar exam, Susan Engonwei Tingwei submitted false timesheets to two D.C. HHAs claiming to provide services that she did not actually render, the DOJ says in a release. Tingwei claimed to be working in the city when her law school key card showed her swiping in and out of campus, among other discrepancies. Tingwei, who is the eleventh former personal care aide since August 2018 to plead guilty to defrauding D.C. Medicaid, is scheduled for sentencing in February. Six of those aides were sentenced to 13 months in prison and one was sentenced to serve 15 months, the DOJ points out.

Also in D.C.: One of the 13-month sentences last month went to Sikirat Adunni Brown, who claimed she was furnishing services when she was actually traveling; submitted 20 hours of services in one day; and paid kickbacks to the supposed patients, among other misdeeds, according to a separate release. Brown defrauded D.C. Medicaid of more than $340,000, the DOJ says.