Julie Wilson, 48, a resident of Pittsburgh, Pennsylvania, pleaded guilty in federal court to one count each of conspiracy to defraud the Pennsylvania Medicaid program and healthcare fraud. During her plea hearing, Wilson admitted that, at various times between 2011 and 2017, she was an employee of Moriarty Consultants, Inc. (MCI) and Everyday People Staffing, Inc. (EPS), two related entities operating in the home healthcare industry. The other entities were Activity Daily Living Services, Inc. (ADL) and Coordination Care, Inc. (CCI). MCI, ADL, and CCI were approved under the Pennsylvania Medicaid program to offer certain services to qualifying Medicaid recipients (“consumers”), including personal assistance services (PAS), service coordination, and non-medical transportation, among other services. Wilson admitted that she was responsible for claims processing and billing matters related to Pennsylvania Medicaid. Between in and around January 2011 and in and around April 2017, MCI, ADL, and CCI, collectively, received more than $87,000,000 in Medicaid payments based on claims submitted for these services, with PAS payments accounting for more than $80,000,000 of the total amount. During that time, Wilson admitted that she participated in a wide-ranging conspiracy to defraud the Pennsylvania Medicaid program 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.
