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Notable BSI Activity in the Fourth Quarter of Fiscal Year 2019

During the quarter, BSI's work led to several guilty pleas and a woman being ordered to pay restitution.

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Dominican National Pleads Guilty to Misusing Social Security Number and Stealing Government Benefits

On April 12, 2019, a Dominican national pleaded guilty in U.S. District Court in Boston to one count of falsely representing a Social Security number and one count of the theft of public money. On July 16, 2019, she was sentenced to one year and one day in prison and two years of supervised release, and ordered to pay $164,987 in restitution. She will be subject to deportation upon completion of her sentence.

BSI’s investigation revealed that in August 2001, the woman used the name, Social Security number, and date of birth of a U.S. citizen from Puerto Rico to apply to participate in the Department of Housing and Urban Development’s Section 8 Program. The woman used the Puerto Rican citizen’s identity to apply for Section 8 benefits, MassHealth benefits, and a Massachusetts driver’s license.

While receiving benefits under the stolen identity, the woman applied for and received additional Section 8 housing vouchers and Supplemental Nutrition Assistance Program (SNAP) benefits using her true name; she received these benefits on behalf of her daughter, who is a U.S. citizen. The woman’s failure to report the income she earned using the stolen identity prohibited these benefit programs from being able to determine her eligibility for them. As a result, the woman received more than $164,000 in federally funded housing assistance, MassHealth, and SNAP benefits.

The U.S. Attorney’s Office’s Major Crimes Unit prosecuted the case.

Pittsfield Woman Ordered to Repay MassHealth Fraud in Full

On April 30, 2019, a Pittsfield woman was ordered to pay restitution totaling $14,946.47 in Pittsfield District Court as a condition of her case being continued without a finding for one year. The woman paid $2,000 on the date of sentencing and was given 18 months to pay the remaining balance in full.

A BSI fraud examiner’s investigation revealed that from July 2017 through November 2017, the defendant stole $14,946.47 in MassHealth benefits by billing MassHealth for personal care attendant services for her mother while her mother was in a nursing home.

Pembroke Man Pleads Guilty, Sentenced for Misusing SNAP Benefits

On June 10, 2019, a Pembroke man pleaded guilty in Plymouth Superior Court for his scheme to defraud the Department of Transitional Assistance. The man, who worked at a group residential facility, used a resident’s electronic benefit card for SNAP benefits to purchase food items without the resident’s knowledge or consent. In total, the man fraudulently used $18,860 of the resident’s SNAP benefits. He pleaded guilty to one count of larceny under $250.

After his plea, the defendant received a sentence of two years of probation and was ordered to repay $3,000 in restitution. The defendant presented to court with the restitution payment in full.

BSI Staff Training

On April 23, 2019, Laura Kessler, Vice President / General Counsel of the Insurance Fraud Bureau (IFB) of Massachusetts, presented training to BSI’s staff about the IFB and the work it does throughout the Commonwealth. Similar to BSI, the IFB was created by statute and is a private investigative agency that investigates suspected fraudulent insurance claims. IFB’s statute gives it the authority to investigate all lines of insurance fraud, and although it handles cases involving disability, property, marine, life, annuity, and health insurance claims, as well as insurance industry insider fraud, it concentrates on automobile and workers’ compensation fraud.

On May 30, 2019, MassHealth staff members presented training to BSI’s staff about recent changes to MassHealth’s eligibility regulations regarding income and household composition for members 64 and under, and for those 65 and over.

These presentations are part of an ongoing series to promote staff education, development, and training. Moreover, these presentations equip BSI’s staff with the tools and information to work smarter and more efficiently in safeguarding the Commonwealth’s public assistance benefit programs.

Date published: August 20, 2019
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