Former Pittsfield Man and Florida Woman Indicted in Connection with Stealing Over $300,000 in Fraudulent MassHealth Benefits
In 2008 , the Attorney General's Office began an investigation after the matter was referred by the Office of the State Auditor's Bureau of Special Investigations (BSI). While living in Massachusetts, Ferdyn, a quadriplegic, received legitimate assistance through the Personal Care Attendant (PCA) program, a benefit provided to MassHealth recipients with long-term disabilities. In December 2003, Ferdyn permanently moved to Florida to reconnect with Edwards, a former girlfriend. Ferdyn was not eligible to receive PCA services from the Florida Medicaid program. Ferdyn then continued to submit claims to the Massachusetts Medicaid program for PCA services he alleged were being provided by Edwards. From July 2004 until the end of May 2005, Edwards was working full time as the Director of Nursing at a Florida nursing and rehabilitation facility. Ferdyn and Edwards submitted claims to the Massachusetts PCA program for dates and times when Edwards was working at the nursing and rehabilitation facility. Authorities further allege that beginning in January 2004 through December 2009, both Ferdyn and Edwards made false statements to MassHealth, stating that Edwards was providing PCA services for Ferdyn at his Massachusetts residence.
MassHealth requires that all members submit applications to determine if they qualify for benefits, and one of the requirements of eligibility is proof of residence. Once a person qualifies for benefits, MassHealth then determines if the person can further participate in the PCA program. To be eligible, MassHealth must make a determination that PCA services are medically necessary. This determination is reviewed annually.
Authorities allege that Ferdyn submitted eligibility forms to MassHealth on an annual basis between 2003 and 2009. In all submissions, Ferdyn fraudulently listed his residency as Massachusetts, while he was actually living in Florida. Each submission was allegedly signed by Ferdyn, with the representation under the pains and penalties of perjury that the submission was complete and accurate to the best of his knowledge. Ferdyn also applied for and was approved for PCA services. Authorities allege that for over five years, when Edwards was Ferdyn's PCA, both Edwards and Ferdyn completed and signed fraudulent timesheets every two weeks and submitted them to MassHealth for payment. Based on the false representations in those timesheets, Edwards was paid over $300,000 for PCA services she gave to Ferdyn.
A Berkshire County Grand Jury returned indictments against both Ferdyn and Edwards yesterday. Both Ferdyn and Edwards will be arraigned in Berkshire Superior Court on April 12, 2010 .
The case is being prosecuted by Assistant Attorney General Nancy Maroney and was investigated by Investigator Meaghan Fogaren, both of Attorney General Martha Coakley's Medicaid Fraud Division. The Massachusetts Bureau of Special Investigations of the Office of the State Auditor, the Boston office of the United States Department of Health and Human Services Office of Inspector General, and the Florida Attorney General's Medicaid Fraud Control Unit also assisted with the investigation.