June 9, 2015

UPMC Claims Department Employee Charged in Fraud Scheme

PITTSBURGH—An Armstrong County woman has been indicted by a federal grand jury in Pittsburgh on charges of mail fraud and health care fraud, United States Attorney David J. Hickton announced today.

The eleven-count indictment named Francine Ann Priestas, 47, of Main Street, Rural Valley, Pa., as the sole defendant.

According to the indictment presented to the court, Francine Ann Priestas was employed as a supervisor in the UPMC Health Plan Claims Department. Priestas generated billing statements which falsely represented that she and others known to the grand jury received medical services. She submitted 156 false statements on the UPMC system and received payments totaling $184,835.

The law provides for a maximum total sentence of 210 years in prison, a fine of $2,750,000 or both. Under the Federal Sentencing Guidelines, the actual sentence imposed would be based upon the seriousness of the offenses and the prior criminal history, if any, of the defendant.

Assistant United States Attorney Robert S. Cessar is prosecuting this case on behalf of the government.

The Federal Bureau of Investigation conducted the investigation leading to the indictment in this case.

An indictment is an accusation. A defendant is presumed innocent unless and until proven guilty.