Pittsburgh woman gets probation in multi-million dollar home health care fraud

A Pittsburgh woman involved in a multi-million dollar fraud home health care fraud scheme was sentenced to four years of probation and ordered to pay more than $94,000 in restitution to the state’s Medicaid program, federal prosecutors in Pittsburgh said Wednesday.

The sentencing of Terra Dean, 46, in U.S. District Court in Pittsburgh, came after she pleaded guilty in January to conspiring to defraud the Medicaid program and health care fraud, the U.S. Attorney’s Office said . Dean admitted to being part of a conspiracy that started around January 2011 and continued to about April 2017, causing the Medicaid program to lose more than $150,000.

Twelve defendants have pleaded guilty for their roles in the conspiracy, prosecutors said.

Dean admitted that when she worked for Moriarty Consultants Inc. of Pittsburgh, one of four related entities operating in the home health care industry, she participated in fraud that processed claims for home health services, non-medical transportation and other services that were never provided.

In the six-years of submitting fraudulent claims, MCI and two related firms got more than $87 million in Medicaid payments.

Some payments were based on the bad claims and documents that were faked to support the claims for payment, including timesheets for “ghost employees.” Some ghost employees were close relatives who never provided help the clients, prosecutors said.

Dean also admitted to paying kickbacks to consumers in exchange for their cooperation in the fraudulent billing scheme.