Personal Care Attendants Arraigned in Connection with Stealing $260,000 from State Medicaid Program
Allegations Include Billing for Services while Incarcerated, Working other Jobs, Charging for a Deceased MassHealth Member, and Other False Billing Schemes
BOSTON – Five former personal care attendants (PCAs) and three PCA surrogates have been arraigned for allegedly defrauding the state’s Medicaid program of approximately $260,000 in total by falsely billing for services that were not provided in a number of separate schemes, Attorney General Martha Coakley announced today. The cases include allegations of billing MassHealth for services while a PCA was incarcerated, and charging for the care of a deceased person, along with several other schemes.
The arraignments follow 32 indictments returned last month by Worcester, Hampshire, and Hampden County Grand Juries and are the result of criminal investigations conducted by AG Coakley’s Medicaid Fraud Division.
All of the cases from the AG’s Office were in collaboration with investigators from the Bureau of Special Investigations of the Office of the State Auditor and the Boston office of the U.S. Department of Health and Human Services Office of Inspector General.
Amarilis Pirela, 33, of Holyoke, was arraigned on March 7 in Hampden Superior Court on the charges of Medicaid False Claims (4 counts) and Larceny over $250 (4 counts). Pirela was released on personal recognizance with the condition that she no longer be a surrogate in the PCA program. Hampden Superior Court Judge Richard Carey presided over the arraignment.
The former PCA surrogate allegedly submitted timesheets for $20,000 worth of PCA services provided by her brother – while he was incarcerated in Massachusetts for illegal possession of a firearm and ammunition – and for services purportedly provided to a MassHealth member who was deceased.
A Hampden Grand Jury returned indictments against Pirela on Feb. 11, 2013. She is due back in court on June 12 for a pretrial hearing.
MARCY KEEGAN GRENACHE & DANIEL KEEGAN
On Feb. 27, Marcy Keegan Grenache, 32, of West Boylston, and her brother, Daniel Keegan, 30, of Holden, were arraigned in Worcester Superior Court for Medicaid False Claims (1 count) and Larceny over $250 (1 count). Both were released on personal recognizance. Keegan was released under the conditions that he no longer serve as a PCA.
Acting as a surrogate, Grenache allegedly hired Keegan as her son’s PCA and submitted fraudulent timesheets for services that were never provided, since Keegan lived outside of Massachusetts at the time, traveled extensively, and maintained conflicting employment. In total, MassHealth paid more than $103,000 for services billed under Keegan’s name, but investigators determined that more than $93,000 of that sum was paid to Keegan for services he never provided.
A Worcester Grand Jury returned indictments against Grenache and Keegan on Feb. 12, 2013. Both are due back in court on March 22 for a pretrial conference.
JAMES LYNCH & HOLLY-BETH RIOPEL
On March 12, James Lynch, 43, of Agawam, and Holly-Beth Riopel, 37, of Palmer were arraigned in Hampshire Superior Court in Northampton on Medicaid False Claims (1 count) and Larceny over $250 (1 count). Both were released on personal recognizance. Riopel was ordered to stay away from the MassHealth member involved. Hampshire Superior Court Judge Mary-Lou Rup presided over the arraignments.
According to authorities, Lynch submitted false timesheets to MassHealth indicating care for a patient while he was working as a bus driver at the Lower Pioneer Valley Educational Collaborative and had an agreement with the consumer to inflate his timesheets and pay half of his checks to the MassHealth member. It is alleged that Lynch billed MassHealth approximately $63,000 pursuant to this scheme. Riopel, a teacher at Palmer Public Schools, allegedly billed MassHealth for $44,000 in services that were not provided.
A Hampshire Grand Jury returned indictments against them on Feb. 12, 2013. Both are due back in court on June 13 for a pretrial hearing.
ALAN & JACQUELINE MORRISSETTE
On March 5, Alan Morrissette, 53, and his wife, Jacqueline Morrissette, 55, of Blackstone were each arraigned in Worcester Superior Court on Medicaid False Claims (4 counts) and Larceny over $250 (4 counts). Both were released on personal recognizance. Worcester Superior Court Judge James Lemire presided over the arraignments.
Jacqueline Morrissette allegedly assisted PCA Alan Morrissette in obtaining money in three separate schemes for a total of approximately $32,000 in PCA services that were never provided by co-signing timesheets as the surrogate for two MassHealth members that lived in their home.
A Worcester Grand Jury returned indictments against the Morrissettes on Feb 12, 2013. Both are due back in court on April 2 for a pretrial conference.
On March 6, Abel Vega, 29, of Jamaica Plain was arraigned in Boston Municipal Court in West Roxbury with charges of Medicaid False Claims (1 count) and Larceny over $250 (1 count) after allegedly defrauding MassHealth of nearly $9,000. He was released on personal recognizance and is due back in court on May 13 for a pretrial conference.
A criminal complaint was issued against Vega in Boston Municipal Court in West Roxbury last month, for allegedly billing for PCA services while the MassHealth member he worked for was either hospitalized or in a long-term care facility.
These cases are being prosecuted by Assistant Attorneys General Joshua Orr, Casey Groff, Ian Marinoff, and David Scheffler, and were investigated by Investigators Michael Russo, Brian Merrick, Gregoire Ucuz, Scott Grannemann and Aleksandra Andriyevskaya, all of Attorney General Martha Coakley’s Medicaid Fraud Division.