PHOENIX, Ariz. – Diana Marie Moore, 44, of Mesa, was sentenced this week by U.S. District Judge Susan M. Brnovich to 66 months in prison, followed by three years of supervised release. Moore was also ordered to pay restitution to the Arizona Health Care Cost Containment System (“AHCCCS”) in the amount of $21,730,674.04. Additionally, the court ordered the forfeiture of four single-family homes owned by Moore, as well as 117 other items, including seven luxury vehicles, designer clothing, high-end jewelry, and artwork. All of the items were purchased by Moore with the proceeds of her fraud scheme. Moore pleaded guilty to wire fraud and money laundering on July 10, 2023.

Moore admitted that she owned two behavioral health counseling services, Harmony Family Services (HFS) and Harmony Family Services II (HFS II), and that she also filed the application for a third behavioral health counseling service, Logan Family Health, LLC (“LFH”). All three subsequently applied to become medical providers for the Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid agency – HFS applied in 2019, HFS II in 2020, and LFH applied in 2022. AHCCCS approved all three applications. When HFS and HFS II applied to AHCCCS, Moore failed to disclose her ownership interest in the other entity. Moore also failed to disclose her prior felony conviction, which was required to be disclosed on the AHCCCS application form.

Moore further admitted to engaging in a fraudulent billing practice targeting AHCCCS and abusing a program that allows Native Americans to seek behavioral health treatment without first obtaining a pre-payment review. Specifically, beginning in January 2020, Moore began obtaining AHCCCS identification numbers for AHCCCS enrollees by paying other providers to transport AHCCCS enrollees to the HFS or HFS II facility for one day, and then obtaining the enrollees’ identification numbers once they arrived. Nearly all of the AHCCCS enrollees for whom Moore received a bill were members of the American Indian Health Plan. After these AHCCCS enrollees left the HFS or HFS II facility, Moore submitted bills to AHCCCS falsely stating that HFS and HFS II had continued to provide services to those same enrollees for up to 90 days. Moore regularly claimed that HFS or HFS II provided counseling services to a particular AHCCCS enrollee for eight or more hours per day, five days per week, for months at a time, even though Moore knew that such services were not being provided. Furthermore, Moore filed claims with AHCCCS falsely claiming that HFS or HFS II provided services to certain AHCCCS enrollees who were in fact deceased or incarcerated at the time Moore claimed to have provided services.

During the sentencing hearing, the Court noted that this type of fraud causes particularly great harm to Arizona’s indigenous people.

“The American Indian Health Plan exists to help an underserved community overcome barriers to treatment,” said U.S. Attorney Gary Restaino. “The defendant abused this program and the unique identification numbers it generated to benefit himself — in some cases by billing for patients she never treated, and in other cases by falsely reporting the duration of treatment. Thank you to the Internal Revenue Service for their financial acumen in bringing the defendant to justice, and to the AHCCCS Inspector General’s Office for their valuable assistance.”

“Diana Moore’s conviction should be a reminder that this type of criminal behavior has serious consequences,” said Carissa Messick, IRS CI Special Agent in Charge, Phoenix Field Office. “IRS CI works methodically to bring fraudsters to justice and restore confidence in our public programs.”

Internal Revenue Service Criminal Investigation conducted the investigation in this case. Assistant U.S. Attorney Aron Ketchel, District of Arizona, Phoenix, handled the prosecution.

CASE NUMBER: CR-23-0040-SMB
PUBLICATION NUMBER: 2024-116_Moore

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