Three St. Louis County individuals were handed prison sentences for submitting fraudulent health care claims totaling over half a million dollars. Doriann Morgan, former owner of A Mother’s Touch In-Home Health Care LLC, received a two-year sentence; Thalisa Walton, the office manager, and Barbara Jackson, the business manager, were given a year and a day each by U.S. District Judge Sarah E. Pitlyk, as the U.S. Attorney's Office of the Eastern District of Missouri reported.
The trio, consisting of Morgan, 59, Walton, 47, and Jackson, 59, entered guilty pleas this past May to a conspiracy charge connected to a scheme in which they admitted to filing $552,659 worth of false reimbursement claims against Missouri's Medicaid program for services they never rendered; this all transpired from roughly January 2018 to August 2021; they did so using the health care company now under new ownership having already paid $790,000 of a $910,000 restitution as part of a civil settlement—the remaining amount due by March next year.
According to the U.S. Attorney's Office, the evidence against the accused included claims for personal care services purportedly provided in Missouri for a woman who was not a resident in the state, and no services were actually given; their plea agreements detailed equally telling social media posts that caught the three in other activities when they were supposedly providing said services.
In her position as business manager, Jackson was tasked with recruiting clients and assigning employees to provide care, while Morgan oversaw the billing of Medicaid and Walton managed the office operations. The civil settlement they settled apparently stemmed from allegations under the False Claims Act that they used doctored timesheets and payroll records to bill for non-provided services. Michele Bickley, who filed the "qui tam" whistleblower lawsuit under the act, will be receiving $90,090 of the recovery, as mentioned in the U.S. Attorney's Office release.
Linda T. Hanley, Special Agent in Charge of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) emphasized the gravity of the offense by stating, "Fraudulent claims submitted to the Missouri Medicaid program diverts scarce resources that should be used to provide legitimate services to those in need, including children and the disabled," in the same release. The HHS-OIG, Missouri Medicaid Fraud Control Unit, and the U.S. Attorney’s Office are committed to upholding the integrity of health safety net programs, and, as the investigation by the HHS-OIG and the Missouri Attorney General's Medicaid Fraud Control Unit demonstrates, the agencies are dedicated to rooting out fraud.
