CLEARFIELD – Two Clearfield women are being accused in a medical assistance fraud scheme that began in December of 2012.
Jessica M. Miller, 45, and Deborah A. Dunsmore, 68, are charged by the Pennsylvania Office of Attorney General with false/fraud medical assistance claim, theft by deception and criminal conspiracy engaging, all felonies.
Both Miller and Dunsmore waived their rights to preliminary hearings Wednesday during centralized court. Their bail is set at $100,000 unsecured.
According to the affidavit of probable cause, on Jan. 31, 2019, the OAG’s Medicaid Fraud Control Section (MFCS) opened an investigation into fraudulent medical assistance claims submitted to the Department of Human Services (DHS).
Miller reportedly provided personal care services to her mother, Dunsmore, through Public Partnerships LLC, a financial intermediary for consumer models of the MA program. She received compensation for PCA services she claimed to have provided between Dec. 30, 2012 and July 21, 2019.
During an interview with investigators, Miller said she only provided PCA services to Dunsmore for four hours per week but intentionally billed PPL for between nine and 24 hours per week.
She allegedly admitted she and Dunsmore would split her paychecks 50/50 until she got another job around March 3, 2015. Then, she said she gave all the money she received from PPL to Dunsmore.
Dunsmore corroborated the information provided by Miller, adding she was aware that Miller was submitting fraudulent timesheets.
As part of the investigation, OAG reviewed timesheets that were submitted by Miller to PPL and checks that she received electronically. During the timeframe, Miller submitted a total of 6,713 hours and 45 minutes for PCA services that were not rendered to MA recipient, Dunsmore.
In total, Miller allegedly received $61,766.50 from PPL, and Medicaid was billed a total of $73,046.05 by PPL.