For Immediate Release - September 06, 2011

Rhode Island Man Pleads Guilty to Defrauding Medicaid System Billing for Services While He Was Incarcerated

Sentenced To Up To Three Years In Prison

FALL RIVER - A Rhode Island man has been sentenced to serve time in State Prison after pleading guilty to defrauding the Massachusetts Medicaid Program of more than $100,000 by claiming that he provided personal care attendant services to an associate while he was in fact incarcerated, Attorney General Martha Coakley's Office announced today.

On September 1, 2011, Bruce Fields, age 34, of Johnston, Rhode Island, pled guilty in Bristol Superior Court to charges of Medicaid False Claims and Larceny by False Pretenses. After the plea was entered, Superior Court Judge E. Susan Garsh sentenced Fields to two to three years in state prison, followed by a five year period of probation. A hearing will be held on September 28, 2011, to determine the amount of restitution owed by Fields.

"This defendant brazenly cheated the system and defrauded taxpayer dollars, billing for health care services he did not perform," AG Coakley said. "We are pleased that the courts agree these crimes should be punished significantly, and we will continue to aggressively protect taxpayer funds."

On March 16, 2011, Susanne Jordan, Fields' co-defendant in the case, age 59, formerly of North Attleboro, also pled guilty to the charges of Medicaid False Claims and Larceny by False Pretenses. Jordan was sentenced to serve two years in the House of Correction, suspended for a five year probationary period.

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). Susanne Jordan was approved to receive assistance under the MassHealth Personal Care Attendant (PCA) program, which is a benefit MassHealth provides to its members with chronic or long-term disabilities. In 1999, Jordan employed Fields as her personal care attendant. During the time period of December 2004 through September 2008, Jordan and Fields submitted fraudulent timesheets to the Massachusetts PCA program, certifying that Fields provided PCA services to Jordan. The two were required to sign forms which indicated that the information contained within was true and accurate to the best of their abilities. During this period, however, records confirmed that Fields was incarcerated at various institutions in Massachusetts and Rhode Island, and therefore unable to have performed the services. Despite Fields' incarceration, Jordan, with Fields' knowledge and consent, continued to submit timesheets on a bi-weekly basis. As a result of these fraudulent statements, MassHealth made reimbursements for the claimed PCA services.

The PCA funds were deposited in a joint bank account that Fields shared with Jordan. Jordan also made frequent visits to Fields while he was incarcerated and deposited money into his canteen account. Based on the false claims made by Jordan and Fields, MassHealth made payments of more than $100,000 for PCA services that Fields never provided.

On April 16, 2010, a Bristol County Grand Jury returned indictments against both Jordan and Fields. They were arraigned in Bristol superior Court on May 7, 2010 and they were released on personal recognizance; however during the pending of the litigation, the state of Rhode Island sentenced Fields to one year in prison on a parole violation. Fields will begin to serve his Massachusetts sentence once his current Rhode Island sentence expires.

Assistant Attorney General Casey Groff, of AG Coakley's Medicaid Fraud Division, prosecuted the case and was investigated by Investigator Scott Grannemann. Investigators from the Bureau of Special Investigations of the Office of the State Auditor and Boston office of the United States Department of Health and Human Services Office of Inspector General also assisted in this case.