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Cranberry woman, family sentenced for $87M Medicaid fraud

A Cranberry Township woman was sentenced Wednesday to 84 months in prison for her role in collecting more than $87 million in illegal state Medicaid payments through four entities she operated with family members.

U.S. District Judge Cathy Bissoon sentenced Arlinda Moriarty, 53, on counts of health care fraud, conspiracy to commit health care fraud, engaging in a scheme to conceal material facts in a health care matter, and aggravated identity theft.

Also charged in connection with the scheme were Moriarty’s sister, Daynelle Dickens, 48, of Pittsburgh and their uncle, Tony Brown, 65. They were charged with health care fraud and conspiracy to commit health care fraud.

Bissoon sentenced Dickens to 24 months in prison and Brown to 36 months of probation, including three months of home confinement. The three were ordered to pay the following in restitution to the Pennsylvania Medicaid program:

– Moriarty, $8.7 million

– Dickens, $1 million

– Brown, $43,113

All three pleaded guilty to the charges in May.

The fraud occurred from January 2011 to April 2017, during which four entities controlled by Moriarty collected more than $87 million in state Medicaid payments based on fraudulent claims, according to U.S. Attorney Cindy K. Chung.

Sixteen people have been charged in connection with the case. Fifteen have been convicted.

The entities, Moriarty Consultants, Activity Daily Living Services, Everyday People Staffing and Coordination Care, were approved by Medicaid for their service to consumers, which included personal assistance, service coordination and additional services.

During proceedings, Moriarty admitted to fabricating state documents to conceal the scheme.

Co-conspirators fabricated time sheets to reflect services never performed and excess hours that should not have been billed, as well as criminal background checks, child-abuse clearances and other documents during the eight-year period. Members of the conspiracy also paid kickbacks to consumers in exchange for their participation in the scheme, Chung said.

“During this elaborate, years-long scheme, Arlinda Moriarty, her sister, and 13 of their co-conspirators stole millions of dollars from a critical government health care program by billing for in-home services that were never rendered,” Chung said. The remaining defendant involved in the case died as the case was investigated, the news release said.

Moriarty and Dickens also admitted causing the periodic bulk submission of fraudulent Medicaid claims for so-called “unused” hours, or excess hours of care that consumers had not needed and therefore should not have been billed. Additionally, Moriarty admitted that during the course of audits of the companies, she directed the fabrication of various documents to submit to state authorities to conceal the Medicaid fraud scheme.

“Moriarty sought to profit by defrauding the Medicaid program,” said Mike Nordwall, FBI Pittsburgh special agent in charge. “She undermined the integrity of federal health care programs and patient trust. Now, she faces the consequences of her actions."

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