Rose Umana Sentenced in $1.1M Medicaid Fraud Scheme

Rose Umana, 49, of Mechanicsburg, Pennsylvania, is going to federal prison for running a rigged medical staffing racket that stole over $1.1 million from Medicaid. The owner and operator of Vision Healthcare Services, Inc., in Harrisburg, Umana was sentenced on December 21, 2016, to 36 months in prison by U.S. District Judge Sylvia H. Rambo after pleading guilty to making false statements related to health care, engaging in monetary transactions with criminally derived property, and identity theft.

Between January 2012 and January 2014, Umana built a paper trail of lies. She forged identification documents and fabricated occupational licenses for unqualified workers. With these fake credentials in hand, she submitted fraudulent bills to Medicaid for services never rendered, billed for care supposedly provided by licensed individuals who never showed up, and charged the government for work done by staff who had no business doing it. Her scheme targeted one of the most vulnerable systems in public health—the Medicaid program that serves low-income and disabled individuals across Pennsylvania.

Medicaid, the joint federal-state program administered in Pennsylvania by the Department of Human Services, was drained of $1,184,224 thanks to Umana’s fraud. Vision Healthcare Services, Inc., a home care and medical staffing firm operating in Dauphin, Cumberland, Perry, and York Counties, had been enrolled in Medicaid since 2006, giving Umana direct access to the government’s purse strings. She exploited that access with precision, treating the system like a personal ATM.

Judge Rambo didn’t let her walk away with just prison time. In addition to the 36-month sentence, Umana was ordered to pay full restitution: $1,184,224. She must also forfeit $656,421 in illicit proceeds. She was instructed to report to the Bureau of Prisons on January 23, 2017, marking the end of her freedom and the beginning of accountability.

The investigation peeled back layers of deception. Federal and state agencies teamed up to bring Umana down: the Office of Inspector General for the U.S. Department of Health and Human Services, the Internal Revenue Service Criminal Investigations, and the Medicaid Fraud Control Section of the Pennsylvania Office of Attorney General. Their work uncovered a web of falsified records, ghost employees, and fraudulent billing that spanned multiple counties and exploited a system meant to protect the weak.

Prosecution was handled by Special Assistant U.S. Attorney Heather M. Albright of the Pennsylvania Attorney General’s Office and Assistant U.S. Attorney Joseph J. Terz. Their case slammed the door on a fraudster who weaponized healthcare bureaucracy for personal gain. Umana’s conviction stands as a warning to others gaming the system: the feds are watching, and the fall from fraud is long and hard.