Ester N. Mbaya, a 43-year-old woman from Harrisburg, Pennsylvania, has been sentenced to 41 months in federal prison for committing health care fraud and bank fraud. She was also ordered to pay restitution of $3,349,550 to the victims of her fraudulent actions, the U.S. Attorney’s Office for the Middle District of Pennsylvania announced on March 3.
Mbaya, who served as the president of Cool Waters, LLC, a home health care agency, fraudulently submitted claims to Medicaid for services that were either not provided or inflated. These fraudulent claims, filed between January 2018 and June 2020, resulted in more than $1 million in improper reimbursements.
In addition to defrauding Medicaid, Mbaya also engaged in bank fraud. She submitted falsified records to secure loans and lines of credit from four financial institutions. This included altering bank statements to inflate her account balances and submitting false paychecks to obtain loans.
Attorney General Dave Sunday commented on the case, saying, “This exhaustive investigation uncovered nearly $3 million in Medicaid funds that should have been used to help Pennsylvanians in need of care, but instead were taken by the defendant who deliberately defrauded the system.”
The sentencing aims to send a clear message to those in the home health care industry and financial institutions: fraudulent claims will not be tolerated, and those who commit such crimes will face significant consequences.
Special Agent in Charge Maureen Dixon of the Department of Health and Human Services Office of the Inspector General (HHS-OIG) added, “This sentencing sends a clear message that home health care providers are required to follow the law and submit only valid claims to Medicaid for reimbursement.”
Mbaya’s case underscores the importance of stringent oversight in both the healthcare and financial sectors, as authorities continue to investigate fraudulent claims and take action against those who attempt to exploit these systems for personal gain.
