Medway Man Pleads Guilty, Sentenced for Defrauding MassHealth and Filing False Insurance Claims
Defendant and Wife Allegedly Profited More Than $1 Million from the Sale of Medical Products Obtained Through Fraudulent Insurance Claims
BOSTON – A Medway man has pleaded guilty and been sentenced 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 Maura Healey announced today.
Vincent Alessandrini, age 52, pleaded guilty on Monday in Suffolk Superior Court to charges of Filing a False Health Care Claim, Larceny Over $250 (4 counts), Medicaid False Claims (2 counts), Larceny Over $250 by False Pretenses (2 counts), and Conspiracy to Commit Health Care Fraud.
“This individual, entrusted to care for his family, took advantage of their situation to turn a personal profit,” said Attorney General Healey. “Our office will continue to be vigilant in pursuing those who defraud state programs.”
After the plea was entered, Judge Carol S. Ball sentenced Alessandrini to two years in the House of Correction, suspended for a probationary period of five years. He was also ordered to pay $57,288 in restitution.
Judge Ball also ordered that Alessandrini no longer serve as a surrogate in MassHealth’s Personal Care Attendant Program (PCA), work as a PCA, work in a position of providing patient care, participate in the sale of medical supplies, or have any contact with the victims.
The MassHealth Personal Care Attendant Program (PCA) helps people with chronic or long-term disabilities live independently and hire personal care attendants to help with their daily living activities. According to authorities, Vincent Alessandrini’s wife, Denise Alessandrini, allegedly served as a surrogate in the PCA program for their twin daughters and two elderly family members residing in the Alessandrini home.
Denise is charged with Filing a False Health Care Claim, Larceny Over $250 (4 counts), Medicaid False Claims (8 counts), Larceny Over $250 by False Pretenses (8 counts), and Conspiracy to Commit Health Care Fraud
Vincent Alessandrini provided PCA services for elderly family members. Denise was allegedly responsible for submitting timesheets and providing payment to the PCAs since 2008. Vincent signed false timesheets and received payment for PCA hours billed in his name while he was working at another job. In total, the defendants allegedly obtained $35,288 in payments from MassHealth based on false timesheets for PCA services that were not actually performed.
In accordance with their care, the Alessandrinis’ twin daughters were prescribed specialized adhesive wound care medical dressings for the alleged treatment of a health condition. The medical dressings were paid for by 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. The Alessandrinis’ ordering requests reached a high in the winter of 2012 when Partners paid out $660,000 on a single bandage order.
From January 2011 through December 2013, Vincent Alessandrini, with alleged assistance from his wife Denise Alessandrini, sought and obtained large amounts of prescription wound care dressings, for the purpose of selling them for a profit. Vincent, allegedly with Denise Alessandrini, sought out customers on the internet and sold them bandages intended for the girls’ care. Several of those customers pre-paid for shipments of wound care bandages and never received them. Authorities estimate that the Alessandrinis stole approximately $335,000 from customers. 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 in November 2014. Vincent Alessandrini pleaded guilty and was sentenced on Monday. Denise Alessandrini is due back in Suffolk Superior Court on June 10.
The case is being handled by Assistant Attorneys General Jennifer Cotter and Jennifer Goldstein of AG Healey’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.