Press Release  Essex County Man Convicted, Sentenced After Trial For Submitting False MassHealth Claims For Autism Behavioral Health Treatment

SALEM — The Massachusetts Attorney General’s Office (AGO) today announced that Donald Martel, age 69, of Georgetown, was convicted after a five-day trial for fraudulently billing MassHealth, the state’s Medicaid program, for applied behavioral analysis (ABA) services that were never provided. Martel was sentenced to three years probation and ordered to pay full restitution, stay away from and have no contact with witnesses, and refrain from all work, billing, and responsibilities with MassHealth members. 

Last week, a jury in Essex County Superior Court found Martel guilty of Medicaid False Claims and Larceny over $1,200. Martel had been indicted in 2022 after an investigation by the AGO’s Medicaid Fraud Division (MFD). MFD’s investigation found that between April 8, 2019 and October 22, 2019, Martel submitted false claims to MassHealth’s ABA subcontractor for ABA services supposedly provided to an individual patient. During this time period, the patient was either incarcerated or in a mental health facility and was not actually receiving those services for which Martel billed the ABA subcontractor. According to the evidence presented at trial, Martel stole at least $33,000 in MassHealth funds.  

ABA services are prescribed therapies provided to people with Autism Spectrum Disorder. MassHealth covers ABA therapy for children under age 21; the treatments include professional, counseling, and guidance services that are necessary to develop and improve their skills. 

This case is part of AG Campbell’s broader efforts to combat ABA provider fraud. In December 2022, the AGO announced $2.5 million in recoveries from two settlements with ABA providers who were alleged to have submitted fraudulent claims to MassHealth for services not provided by individuals with appropriate credentials, not properly documented, and/or noncompliant with supervision requirements established by MassHealth and its managed care entities.

This case was investigated and prosecuted by Assistant Attorneys General William Champlin and Joanna Staley, Senior Healthcare Fraud Investigator Heather Dwyer, and Investigator Kevin Todd, all of the AG’s Medicaid Fraud Division. MassHealth, Carelon, the Essex County Sheriff’s Department, Fuller Hospital, and Worcester Recovery Center and Hospital provided substantial assistance with the investigation and trial.

The AGO’s Medicaid Fraud Division is a Medicaid Fraud Control Unit, annually certified by the U.S. Department of Health and Human Services to investigate and prosecute health care providers who defraud the state’s Medicaid program, MassHealth. The Medicaid Fraud Division also has jurisdiction to investigate and prosecute complaints of abuse, neglect and financial exploitation of residents in long-term care facilities and of Medicaid patients in any health care setting. Individuals may file a MassHealth fraud complaint or report cases of abuse or neglect of Medicaid patients or long-term care residents by visiting the AGO’s website.   

The Massachusetts Medicaid Fraud Division receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $5,922,320 for federal fiscal year 2025. The remaining 25 percent, totaling $1,974,102 for FY 2025, is funded by the Commonwealth of Massachusetts.

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