For Immediate Release - March 31, 2014

Former Personal Care Attendant Pleads Guilty to Defrauding $63,000 From State Medicaid System

NORTHAMPTON – A former Personal Care Attendant (PCA) from Agawam has pleaded guilty to stealing close to $63,000 from the state’s Medicaid program (MassHealth) for services that were not provided, Attorney General Martha Coakley announced today.

James Lynch, 45, pleaded guilty today in Hampshire Superior Court to charges of Medicaid False Claims (1 count) and Larceny over $250 (1 count).

“This man conducted a scheme that charged the state Medicaid program for hours in care and services that was never provided,” AG Coakley said. “Our office is committed to holding accountable those who take advantage of MassHealth, which many people rely on for critical health care coverage.”

After the pleas were entered, Superior Court Judge C. Jeffrey Kinder sentenced Lynch to five years of probation. As a condition to his probation, Judge Kinder ordered that Lynch not be involved in the PCA program in any capacity, and pay more than $63,000 in restitution.

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. It is also alleged that Lynch had an agreement with the MassHealth member to inflate his timesheets and pay half of his checks to the member. Lynch billed MassHealth approximately $63,000 pursuant to this scheme.

Holly-Beth Riopel was indicted on the same charges, alleging she billed MassHealth for $44,000 in services to the MassHealth member’s daughter from 2006 to 2008 that were not provided. Riopel is due back in court on April 17 for a pretrial conference.

A Hampshire County Grand Jury returned indictments against Lynch on Feb. 12, 2013. He was arraigned on March 12, 2013.

The MassHealth PCA Program helps people with chronic or long-term disabilities live independently. The program provides funds to pay PCAs who help patients with Activities of Daily Living while members receiving the services act as the PCA’s employer. By regulation, PCA services cannot be provided while a MassHealth member is admitted to an inpatient facility or nursing home.

The case is being prosecuted by Assistant Attorney General Angela Neal and was investigated by Investigator Scott Grannemann, both of Attorney General Martha Coakley’s Medicaid Fraud Division. The case was 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.

###############

Follow us on Twitter – View our Photos – Visit our Website