Pennsylvania Resident Plead guilty to Conspiracy and Health Care Fraud
Keith Scroggins, 54, plead guilty to one count each of conspiracy to defraud the Pennsylvania Medicaid Program. During his hearing yesterday, he admitted that between the years 2011 and 2017 admitted that he 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. As part of the conspiracy, Scoggins admitted that he fabricated timesheets to reflect the provision of in-home PAS care that, in fact, he never provided to the consumer.
During that time Scroggins was an employee of Moriarty Consultants, Inc. (MCI), one of four related entities operating in the home health care industry. The other three entities were Activity Daily Living Services, Inc. (ADL), Coordination Care, Inc. (CCI), and Everyday People Staffing, Inc. (EPS). 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. 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.
The conspiracy and health care fraud charges each carry a maximum total sentence of not more than 10 years in prison, a fine of $250,000, or both. Under the Federal Sentencing Guidelines, the actual sentence imposed would be based upon the seriousness of the offense and the prior criminal history, if any, of the defendant.
To date, a total of sixteen defendants have been charged in connection with this investigation. Scoggins is the ninth defendant to enter a guilty plea. The remaining defendants are presumed innocent unless and until proven guilty.