Four home health workers from Pittsburgh stand accused of criminal Medicaid fraud.

Defendants Travis Moriarty, Tiffhany Covington, Autumn Brown and Brenda Lowry have been accused by the U.S. Attorney’s Office for the Western District of Pennsylvania. The four Pittsburgh residents were charged in federal court on Monday, Oct. 22, 2018.

According to Law360, the defendants purportedly submitted false claims for personal care services to the U.S. government, engaging in Medicaid fraud amounting to millions of dollars. The false claims were allegedly submitted via a few interrelated companies and their employees. These employees did not perform the work indicated, according to the U.S. attorney.

The Medicaid fraud was allegedly committed using the names of patients who could not have received personal care services at the times indicated due to hospitalization, imprisonment, or death.

The four defendants also stand accused of paying kickbacks to individuals if they would agree to participate and support the false claims documented through the submission of inaccurate timesheets.

Between January 2011 and April 2017, the companies listed as Moriarty Consultants Inc., Activity Daily Living Services Inc., and Coordination Care Inc. allegedly received $80 million for personal assistance services from Medicaid. Another $7 million dollars was allegedly received from Medicaid for other services collectively as well. The exact monetary figure of the alleged Medicaid fraud has not yet been precisely determined.

The four were all employees of one or more of these three companies which were licensed to offer home health care under the Pennsylvania Medicaid Program. An additional company that served as the administrative support for the three health care companies allegedly assisted with the falsification of timesheets necessary to back up their false claims.

According to Law360, prosecutors are saying that the four home health workers even went so far as to submit false claims under the names of employees who didn’t exist or were people who didn’t know their personally identifiable information was being used.

When the efforts were successful, monies were allegedly skimmed from the salary payments part of the disbursement to pay one or more of the four co-conspirators for services that were never rendered in the first place.

Prosecutors also allege that Moriarty and Covington presented other fraudulent documentation as part of their Medicaid fraud cover up, including criminal background checks and child abuse history clearances. This was purportedly done so that the companies could pass state audits that might have unearthed the alleged conspiracy.

The four co-conspirators have not been indicted, but rather charged by information by conspiracy to commit health care fraud. This reveals a willingness on their part to work with authorities and register pleas which might reduce their sentences, according to Law360.

Without reduction, each defendant could face up to ten years in prison or have to pay a fine of $250,000.