HARRISBURG, Pa. — The United States Attorney's Office for the Middle District of Pennsylvania announced that Ester N. Mbaya, 43, of Harrisburg, pleaded guilty to charges of health care and bank fraud on Tuesday.
According to United States Attorney Gerard M. Karam, Mbaya was president of Cool Water, LLC, a home healthcare agency. Mbaya submitted fraudulent Medicaid claims seeking compensation for services that were not provided or inflated claims. Mbaya submitted these fraudulent claims from Jan. 2018 to June 2020 and obtained over $1 million as a result of the fraud.
Mbaya also reportedly submitted falsified records to four financial institutions to obtain loans and lines of credit. The falsified records included altered bank statements which made it appear she had more money on deposit than she did. She also submitted falsified paychecks to obtain loans.
"The diligent work of law enforcement collaborators uncovered a criminal scheme that diverted money from in-need Pennsylvanians who could have benefitted from the Medicaid program," Pa. Attorney General Michelle Henry said. "Our office is proud to work with partners who share the mission of making sure Medicaid dollars pay for care and services that enhance quality of life, rather than line the pockets of bad actors."
"Medical providers must strictly follow the law when billing Medicaid for services," said Special Agent in Charge Maureen Dixon of the Department of Health and Human Services Office of Inspector General (HHS-OIG). "Alongside our law enforcement partners, HHS-OIG will continue to investigate inaccurate billings submitted to federally funded health care programs."
The case was investigated by the U.S. Office of Inspector General for the U.S. Department of Health and Human Services and the Pennsylvania Office of Attorney General. Special Assistant U.S. Attorney Christopher Sherwood and Assistant U.S. Attorney Michael Consiglio are prosecuting the case.
The maximum penalty under federal law for these offenses is 40 years in prison, followed by a term of supervised release and a fine.
