- Office of Attorney General Maura Healey
Media Contact for AG Healey Indicts Seven Individuals in Connection With Personal Care Attendant Fraud
BOSTON — Attorney General Maura Healey announced today that her office secured indictments against seven individuals in connection with a coordinated criminal sweep of fraud and abuse in the state’s Personal Care Attendant (PCA) program offered by MassHealth.
“More people than ever rely on MassHealth resources for the care they need to stay in their homes. We need to make sure that those resources are not being used for fraudulent payments,” said AG Healey. “I’m grateful to my state and federal partners for providing critical support in these investigations.”
The Attorney General’s Medicaid Fraud Division, together with the Office of the Inspector General and the State Auditor’s Bureau of Special Investigations, lead a PCA Taskforce that collaborates to investigate and prosecute fraud and abuse in the MassHealth PCA program. This collaboration was critical during the sweep.
“Personal care attendant fraud deprives vulnerable Massachusetts residents of the very home services they rely on, while disregarding the taxpayers funding those services,” said Phillip M. Coyne, Special Agent in Charge, Office of the Inspector General of the U.S. Department of Health and Human Service’s Boston Regional Office. “I appreciate the partnership with the Medicaid Fraud Division of the Massachusetts Attorney General’s Office in identifying and prosecuting such schemes.”
“As this critical program expands, so do the number of people trying to abuse it. This collaboration across state and federal law enforcement represents our collective determination to discourage and punish this abuse,” said State Auditor Suzanne M. Bump.
The MassHealth PCA Program helps people live independently in the community by providing medically necessary physical assistance with personal care needs. Through the consumer driven MassHealth PCA program, eligible MassHealth members employ PCAs to assist them with their activities of daily living. These services are paid for by MassHealth through a fiscal intermediary.
“The PCA Program is a unique, consumer-directed program that supports some of MassHealth’s most vulnerable members with daily living activities,” said Dan Tsai, Assistant Secretary for MassHealth and Medicaid Director. “Several of these indictments were the result of MassHealth referrals, and demonstrate the agency's ongoing efforts to further improve program integrity in the PCA program, including identifying fraud, waste, and abuse.”
Statewide and Suffolk County Grand Juries returned the following indictments:
Chantel Bethea, 41, and Robert L. Evans III, 44, of Worcester
Chantel Bethea and Robert L. Evans III were indicted by a Statewide Grand Jury for Medicaid False Claims (1 count), and Larceny Over $1200 (1 count). Bethea was also indicted for Neglect of an Elder or Disabled Person (1 count). The defendants will be arraigned in the Worcester Superior Court at a later date. Prosecutors allege that between December 2015 and February 2019, Bethea and Evans fraudulently billed MassHealth for PCA services that were not rendered to an elderly individual with long-term disabilities. Additionally, it is alleged that Bethea neglected the consumer, a MassHealth member, by failing to provide necessary assistance with daily living such as food/grocery shopping, cleaning clothes, bathing, housekeeping and other services, for long periods of time. In total, the AG’s Office alleges that the defendants fraudulently obtained more than $120,000.
Abdikadir Maow, 48, and Abdinafa Maow, 26, of Medford
Abdikadir and Abdinafa Maow were both indicted by a Statewide Grand Jury for Medicaid False Claims (1 count each) and Larceny over $1,200 (1 count each). They were arraigned in Middlesex Superior Court on October 8, 2020, where they both pleaded not guilty to the charges. They are scheduled to appear in Middlesex Superior Court on Oct. 29 for a scheduling conference.
The AG’s Office alleges that from 2015 to May of 2020, Abdikadir Maow and his PCA, Abdinafa Maow, participated in a scheme to falsely submit timesheets for PCA services that were not actually rendered, billing and getting paid for PCA hours purportedly provided during times when Abdinafa Maow was working at a secondary employer or while one or both of the defendants were traveling or residing out of the country separately for long periods of time. In total, it is alleged that the defendants fraudulently obtained more than $100,000 from MassHealth.
Kyisha Vargas, 40, of Holliston and Howard Britt, 72, of Dorchester
Kyisha Vargas was indicted by a Suffolk County Grand Jury for Medicaid False Claims (2 counts), Larceny over $1200 (1 count), and Identity Fraud (1 count). Howard Britt was indicted by a Suffolk Grand Jury for Medicaid False Claims (1 count). Vargas and Britt were arraigned in Suffolk Superior Court on October 14, 2020, where they pleaded not guilty to the charges. Both defendants are due back in Suffolk Superior Court on Nov. 18 for pretrial conference.
Prosecutors allege that between April 2016 and August of 2020, Vargas fraudulently used another person’s personal identifying information and billed for PCA services not provided to the consumer, Howard Britt, under that name. Additionally, she billed for PCA services that were not provided to Britt during a period of time when she was incarcerated. It is alleged that Britt participated in this fraud during Vargas’ incarceration. In total, it is alleged that the defendants fraudulently obtained more than $44,450 from MassHealth.
Amy Sutherland (aka Amy Petrucelli), 48, of Worcester
Amy Sutherland was indicted by a Statewide Grand Jury for Medicaid False Claims (1 count) and Larceny over $1,200 (1 count). She will be arraigned in Worcester Superior Court at a later date. The AG’s Office alleges that from August 2017 to August 2019, Sutherland falsely submitted timesheets for PCA services provided to her by “Amy Petrucelli,” which prosecutors believe is her maiden name, and that these two individuals are, in fact, the same person. In total, it is alleged that Sutherland fraudulently obtained more than $37,000 from MassHealth.
Members of the public who are aware of similar practices by those involved in the PCA program or by other health care providers should call the Attorney General’s Medicaid Fraud Division at (617) 963-2360 or file a complaint through the Attorney General’s website.
These matters are being investigated and prosecuted by Assistant Attorneys General Christina Chan, Ali Russo, and William Champlin, Senior Trial Counsel Elisha Willis, Senior Healthcare Fraud Investigators Aleksandra Andriyevskaya and Andrew Lutynski and Investigator Matthew Baldwin, all from AG Healey’s Medicaid Fraud Division. Investigations Supervisor Dean Bates of the AG’s Medicaid Fraud Division, the Massachusetts State Police assigned to the AG’s Office, the U.S. Department of Health and Human Services, Office of the Inspector General and the Massachusetts State Auditor’s Bureau of Special Investigations provided critical assistance to these investigations. Substantial cooperation was received throughout the AG’s investigations from MassHealth, Tempus Unlimited, Stavros and Commonwealth Care Alliance. The Medicaid Fraud Division receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award. The remaining 25 percent is funded by the Commonwealth of Massachusetts.