Attorney General Maura Healey.
A Haverhill woman, one of five personal care attendants (PCA) or surrogates indicted last month for allegedly defrauding MassHealth by billing for services not rendered, is due to be arraigned Monday on larceny and other charges in Essex Superior Court.
Crystal Clark, 36, of Haverhill, was indicted by an Essex County Grand Jury Feb. 11 on three counts of Medicaid false claims and three counts of larceny over $250 by false pretenses, according to a statement from Attorney General Maura Healey’s office. The charges stem from an investigation by Healey’s Medicaid Fraud Division, with assistance from Healey’s Victim/Witness Services Division and the State Auditor’s Office. Authorities allege Clark billed MassHealth more than $64,000 for services that were not provided. According to authorities, Clark served as the PCA surrogate for her disabled son and allegedly submitted timesheets certifying that more than 4,000 hours of PCA services were provided to him by Clark’s eldest son, boyfriend, and brother between January 2010 and November 2015.
“However, the investigation revealed that, during these times, the PCAs identified on the timesheets were often working elsewhere and could not have been providing PCA services,” a spokesperson said. “Clark falsely represented that these services were rendered using photocopied timesheets and falsified signatures.”
In separate cases, Clark and four others were charged with allegedly defrauding the state’s Medicaid program a total of more than $230,000 by either falsely billing for services not rendered or double billing. A total of 18 indictments were also returned by Plymouth, Berkshire and Worcester County Grand Juries as the result of criminal investigations conducted by Healey’s Medicaid Fraud Division. A criminal complaint, including charges of neglecting a disabled person, was also issued against a PCA who was to be arraigned in Boston Municipal Court.
The cases include allegations of billing MassHealth for services that were not provided, double billing for PCA and adult foster care (AFC) services, and charging for home care when a patient was hospitalized, along with several other schemes.
“MassHealth provides critical healthcare services for people who otherwise cannot afford them,” Healey said. “We allege that these individuals exploited this system and defrauded taxpayers, while at the same time diverting resources from those in need.”
The AG’s Office conducted these investigations with assistance from the Massachusetts Executive Office of Health and Human Services and the U.S. Department of Health and Human Services—Office of the Inspector General.
Imagine if our AG/Beacon Hill actually wanted to go after real fraud? Talk about low hanging fruit.