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Fraud

Pennsylvania Attorney General's Office Leads to Federal Plea for Healthcare Fraud

Strategic Insights

— 1 min read

Pennsylvania Attorney General's Office led a comprehensive investigation into SerenityCare LLC, a Pittsburgh-based provider of home and community-based services for intellectually and physically disabled adults. The investigation revealed that the company's CFO, Kelley Oliver-Hollis, falsified staffing numbers to overbill Pennsylvania Medicaid by over $1.5 million. Oliver-Hollis pleaded guilty to healthcare fraud and agreed to pay restitution at sentencing. This successful outcome highlights the importance of interagency collaboration in preventing healthcare fraud and protecting vulnerable populations.

Key Takeaways:

  • The Pennsylvania Attorney General's Office played a significant role in investigating and prosecuting the case, along with the Federal Bureau of Investigation and other federal, state, and local partners.
  • Kelley Oliver-Hollis, CFO and half-owner of SerenityCare LLC, pleaded guilty to healthcare fraud for falsifying staffing numbers to overbill Pennsylvania Medicaid.
  • The investigation revealed that the company operated six residences and a day program center within Allegheny County, which received numerous citations for unsanitary and unsafe living conditions.
  • Medicaid Fraud Control Section investigators from the Western Regional Office were a key part of the investigative team, supporting the work of the FBI, HHS, SSI, IRS, and Allegheny County District Attorney's Office.
  • Senior Deputy Attorney General Kee Song and Deputy Attorney General Nathan Michaux assisted during the investigative and prosecutorial phases of the case.
  • The case highlights the need for interagency collaboration in preventing healthcare fraud and protecting vulnerable populations.

Statistics:

  • 75% of the Pennsylvania Medicaid Fraud Control Unit's funding comes from the U.S. Department of Health and Human Services under a grant award totaling $12,839,940 for Federal fiscal year (FY) 2025.
  • 25% of the unit's funding comes from Pennsylvania, totaling $4,279,979 for FY 2025.

Sources:

  • Pennsylvania Attorney General's Office - https://www.attorneygeneral.gov/taking-action/office-of-attorney-generals-role-in-investigating-owner-of-pittsburgh-facility-for-intellectually-disabled-adults-leads-to-federal-plea-to-health-care-fraud/

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