Mesa business owner sentenced to 5 years for health care fraud

PHOENIX — A Mesa woman was sentenced this week to 66 months in prison for defrauding Arizona’s Medicaid program.

Diana Moore was also ordered to pay more than $21 million in restitution to the Arizona Health Care Cost Containment System (AHCCCS) after pleading guilty to wire fraud and money laundering on July 10, 2023.

The 44-year-old fraudulently billed AHCCCS, per the U.S. Attorney’s Office of Arizona. She took advantage of a billing program that allows Native Americans to receive healthcare before a pre-payment review. Almost all of the AHCCCS enrollees Moore billed were part of the American Indian Health Plan.

Moore was the owner of two behavioral health counseling services, Harmony Family Services and Harmony Family Services II, and also applied for another behavioral health counseling service, Logan Family Health, LLC.

In January 2020, Moore started collecting identification numbers of AHCCCS members by paying other providers to transport members to her own facilities for a single day.

After the members left her facilities, she would bill AHCCCS and claim she provided those members treatment for up to 90 days.

Moore falsely claimed her facilities provided counseling services to enrollees for at least eight hours each day, five days a week, for months at a time, despite Moore not providing those services.

She was ordered to forfeit four homes, seven luxury cars, designer clothes, luxury jewelry and artwork. All of the items, totaling more than 100 items, were bought by Moore via the money she obtained through her fraud scheme.

“The sentencing of Diana Moore should be a reminder there are serious consequences to this type of criminal behavior,” Carissa Messick, IRS CI Special Agent in Charge, Phoenix Field Office, said in a press release. “IRS CI methodically works to bring fraudsters to justice and restore confidence in our public programs.”

During the sentencing, the court said Moore’s fraud disproportionately affected the Native American populations in Arizona.

“The American Indian Health Plan exists to help an underserved community surmount barriers to treatment,” United States Attorney Gary Restaino said in a press release. “Defendant misused this program, and the unique identification numbers generated by it, to benefit herself — in some cases by billing for patients she never treated, and in other cases by falsely inflating the duration of treatment. Thanks to the Internal Revenue Service for its financial acumen in bringing defendant to justice, and to the AHCCCS Inspector General’s Office for its valuable assistance.”

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