BOISE – Karina Renee Moore, 48, of Eagle, was sentenced to 37 months in federal prison for health care fraud, U.S. Attorney Bart M. Davis announced today. U.S. District Judge B. Lynn Winmill also ordered Moore to serve three years of supervised release following her release from prison and to pay $611,860.86 in restitution. Moore pleaded guilty on January 7, 2020.
According to court records, from August 2007 to December 2016, Moore was employed as the office manager at a skilled nursing facility in Boise. The skilled nursing facility was originally Marquis Care of Shaw Mountain, but it was sold in May 2016 and renamed Shaw Mountain of Cascadia. On December 1, 2016, employees at Shaw Mountain of Cascadia called law enforcement after discovering checks showing that the defendant had embezzled $23,805.66. The resulting investigation revealed Moore had been defrauding the Shaw Mountain care facility since at least January 2010. Between January 2010 and December 2016, Moore defrauded health care programs and social security programs, resulting in a loss of $611,860.86.
Moore used multiple schemes to cover her fraud. She embezzled the residents’ private payments and social security payments, including from their resident trust accounts. She fraudulently billed Medicaid for services that were covered by other health care benefit programs, and failed to report payments to Medicaid, causing overpayments, which she then embezzled. Finally, Moore collected and misused the social security checks of a deceased resident.
This case was investigated by United States Department of Health and Human Services Office of Inspector General, Boise Police Department, and Social Security Administration Office of Inspector General.