For Immediate Release - November 13, 2014

Medway Couple Charged in Connection with Defrauding MassHealth and Filing False Insurance Claims

Defendants Allegedly Profited More Than $1 Million from the Sale of Medical Products Obtained Through Fraudulent Insurance Claims

BOSTON – A Medway husband and wife have been charged in connection with fraudulently billing MassHealth and profiting more than $1 million from the sale of medical products obtained through the filing of false health care claims, Attorney General Martha Coakley announced today. 

“The Personal Care Attendant Program is funded with the distinct purpose of assisting individuals with long term disabilities with their daily lives,” AG Coakley said. “We allege this couple wrongfully billed MassHealth and resold valuable medical supplies for profit.” 

A Suffolk Superior Statewide Grand Jury returned indictments on Monday against Denise Alessandrini, 48, and her husband Vincent Alessandrini, 51. The defendants are charged as follows:

Denise Alessandrini

  • Filing False Health Care Claim
  • Larceny Over $250 (4 counts)
  • Medicaid Fraud (8 counts)
  • Larceny Over $250 by False Pretenses (8 counts)
  • Conspiracy to Commit Health Care Fraud

Vincent Alessandrini

  • Filing False Health Care Claim
  • Larceny Over $250 (4 counts)
  • Medicaid Fraud (2 counts)
  • Larceny Over $250 by False Pretenses (2 counts)
  • Conspiracy to Commit Health Care Fraud

The MassHealth Personal Care Attendant Program (PCA) helps people with chronic or long-term disabilities live independently and hire PCA’s to help with their daily living activities. According to authorities Denise Alessandrini served as a surrogate in the PCA program while family members served as the PCAs in charge of her twin daughters’ care who suffered from various medical conditions.

In her capacity, Denise was responsible for submitting timesheets and providing payment to the PCAs since 2008. In addition, Vincent Alessandrini provided PCA services for elderly family members who previously served as PCAs to their daughters, since 2013.

Authorities allege that at various times between September 2008 through April 2014, Denise submitted falsified timesheets on behalf of PCAs that either conflicted with existing work or school schedules or at times when the PCA could not otherwise provide services. Vincent also signed false timesheets and received payment for PCA hours billed in his name while he was working at another job. As a result of the information allegedly provided, MassHealth overpaid the Alessandrinis more than $34,000. 

In accordance with their care, the twins were prescribed specialized adhesive wound care medical dressings for the alleged treatment of a health condition. The medical dressings were paid for by the family’s health insurer, Partners Healthcare, and the plan was administered by Tufts Health Plan (THP). In September 2011, THP’s fraud prevention unit initiated an internal investigation after identifying a significant uptick in the number of advanced wound care medical dressings being prescribed and ordered on behalf of the twins.

Authorities allege that between January 2011 through December 2013, Denise and Vincent Alessandrini sought, and obtained, large amounts of prescription wound care dressings for the purpose of selling them for a profit. Denise and Vincent Alessandrini sold these bandages to customers via the internet. Several of those customers pre-paid for shipments of wound care bandages and never received them. Authorities allege that these customers are owed approximately $335,000. As a result of this scheme, authorities allege the resale of these specialized bandages resulted in a profit of more than $1 million. 

A Suffolk Superior Statewide Grand Jury returned indictments against Denise and Vincent Alessandrini on Monday. The defendants are scheduled to be arraigned in Suffolk Superior Court at a later date. These charges are allegations, and the defendants are presumed innocent until proven guilty.

The case is being handled by Assistant Attorneys General Jennifer Cotter and Jennifer Goldstein of AG Coakley’s Insurance and Unemployment Fraud Division and Medicaid Fraud Division with assistance from investigators Philip Mantyla and Gregoire Ucuz of the Attorney General’s Office and assistance from the Insurance Fraud Bureau of Massachusetts and the Massachusetts State Police.

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