Pennsylvania Nursing Home Worker Acquitted of Federal Health Care Fraud Charges

A nursing home company regional consultant charged with health care fraud has been acquitted on all of the government’s counts against her after a five-week federal trial in the Western District of Pennsylvania.

Ballard Spahr attorneys Beth Moskow-Schnoll and Matthew G. Kussmaul successfully defended Michelle Romeo, who served as a regional consultant for nursing assessment coordinators (NACs) at 17 nursing homes in western Pennsylvania. Prosecutors alleged that Ms. Romeo, as part of a wide-ranging, seven-year conspiracy, directed NACs to falsify residents’ assessments to reflect more care than the residents actually needed, in an illegal scheme to receive inflated reimbursements from Medicare and Medicaid.

On December 18, following testimony and arguments before U.S. District Judge Robert J. Colville, the jury found Ms. Romeo not guilty of health care fraud and conspiracy.

“It was clear to me that the prosecutors did not understand the regulations that govern resident assessments—regulations we used to show that our client was simply doing her job lawfully,” said Ms. Moskow-Schnoll, partner in Ballard Spahr’s White Collar Defense/Internal Investigations Group and co-leader of the firm’s Health Care industry team. “Through our cross-examinations of the government’s witnesses, we were able to show the jury that our client was pushing the NACs to do their jobs per regulations promulgated by the Centers for Medicare & Medicaid Services (CMS), and not asking them to commit fraud as the government alleged.”

Through their defense case, Ms. Moskow-Schnoll and Mr. Kussmaul successfully educated the jury about resident assessments, CMS regulations pertaining to them, and the legitimate nature of Ms. Romeo’s actions to maximize reimbursements—which prosecutors had portrayed as nefarious. In particular, cross-examination of the prosecution’s star witness—a former colleague testifying against Ms. Romeo under a grant of immunity—exposed to the jury the witness’s lack of credibility, including a prior conviction for lying to law enforcement officials.

The charges against Ms. Romeo were part of a broader 2022 indictment in which the U.S. Attorney’s Office for the Western District of Pennsylvania brought more than a dozen counts against three other individual employees, one of the owners of the company, and two nursing homes—Brighton Rehabilitation in Beaver County and Mt. Lebanon Rehabilitation and Wellness Center in Allegheny County. Prosecutors alleged a wide-ranging, illegal scheme to cheat the government and maximize profits at the expense of resident care. Each of the counts against Ms. Romeo carried a maximum sentence of 10 years imprisonment and a $250,000 fine.

In addition to Ms. Romeo, the four individual defendants were acquitted. The two nursing homes were found guilty of multiple counts of making false statements in connection with the payment of health care benefits.

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