Autumn Brown, Health Care Fraud, Pennsylvania 2018

Two Pittsburgh residents have been sentenced to five years of probation for their roles in a multi-million dollar health care fraud conspiracy in Pennsylvania.

Autumn Brown, 31, and Brenda Lowry Horton, 48, were ordered to pay restitution to the Pennsylvania Medicaid program in the amount of $68,917.80 and $67,107.32, respectively, for their involvement in a years-long scheme to defraud the Pennsylvania Medicaid program.

According to court documents, the defendants admitted to participating in a conspiracy to submit fraudulent claims for services that were never provided to Medicaid recipients or for which there was insufficient or fabricated documentation to support the claims.

The scheme, which involved multiple related entities, including Moriarty Consultants, Inc. (MCI), Activity Daily Living Services, Inc. (ADL), and Everyday People Staffing, Inc. (EPS), collectively received more than $87,000,000 in Medicaid payments based on claims submitted for services between January 2011 and April 2017.

During their plea hearings in December 2018, the defendants admitted that they fabricated timesheets to reflect the provision of in-home personal assistance care that never occurred and that they paid kickbacks to consumers in exchange for signing or allowing their names to be forged on false timesheets.

To date, 16 people have been charged with offenses related to the conspiracy, which was investigated by the Federal Bureau of Investigation, Pennsylvania Office of the Attorney General – Medicaid Fraud Control Unit, Internal Revenue Service – Criminal Investigation, U.S. Department of Health and Human Services – Office of Inspector General, and United States Postal Inspection Service.

Assistant United States Attorney Eric G. Olshan and Special Assistant United States Attorney Edward Song are prosecuting this case on behalf of the government.

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