http://eagletimes.villagesoup.com/p/springfield-woman-among-those-arrested-for-medicaid-fraud/1158906
Springfield woman among those arrested for Medicaid fraud
By Chris Garofolo | Mar 29, 2014 Share on facebook Share on gmail Share on blogger Share on print More Sharing Services
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WHITE RIVER JUNCTION, VT. — A Springfield woman was one of four Vermont individuals arrested this month on felony counts of Medicaid fraud, collectively submitting fraudulent timesheets that resulted in thousands of dollars paid out for bogus services.
The Medicaid Fraud & Residential Abuse Unit within the Vermont Attorney General’s Office reported 55-year-old Theresa Ambrose, of Springfield, was arraigned Tuesday on one felony count of fraud for allegedly filing trumped up timesheets that resulted in roughly $4,800 in overpayments from the state Medicaid program.
She pleaded not guilty and released without bail.
A felony Medicaid fraud charge carries a maximum penalty of up to 10 years in prison and fines equal to twice the amount of payments wrongfully obtained.
Ambrose was one of four women enrolled as a caregiver in Medicaid programs who was issued a citation for allegedly billing the state for services that were never provided. In total, the four suspects filed 34 false timesheets for nearly 2,000 hours of fraudulent work.
Court documents obtained by the Eagle Times indicates Ambrose was employed to a family member in Springfield enrolled as part of the Choices for Care Medicaid program.
From October 2012 to late November 2013, she knowingly submitted seven forms to ARIS Solutions, the state-contracted payroll facilitator, for a total of $4,841.
The Attorney General’s office was first contacted in November 2012 about possible Medicaid fraud by local case manager Patty Jones from the Area Agency on Aging in Springfield.
When Ambrose was hired as a personal caretaker, Jones became aware she was also working on a full-time basis outside the home and questioned how she would be able to render services in both locations.
The family responded that Ambrose was to take a few weeks of vacation time and her job was “flexible enough” to continue her care for the recipient.
Jones reportedly visited the residence on Oct. 15, 2012 for a home visit and noted Ambrose was not present. She observed, however, Ambrose alleged to have provided personal care services that entire day, court records indicate.
It was later confirmed by Jones that Ambrose also claimed to work an eight-hour day at her full-time job at Youth Educational Employment Services (YEES) in additional to the 16 hours of care services at home.
“Theresa Ambrose submitted seven timesheets to ARIS. For 32 of the days on these timesheets, Theresa Ambrose claimed that she provided [the recipient] with 16 hours of care (personal and respite),” said Virginia Merriam, a detective with the fraud unit in the Attorney General’s office, in an affidavit. “On each of these 32 days, Theresa Ambrose also purportedly worked a full eight-hour day for YEES. Theresa Ambrose, therefore, claimed that she worked for 24 hours a day on each of the 32 days.”
According to the reports observed by Merriam, Ambrose claimed to have worked 120 hours in a row — 24 hours a day for five straight days.
Along with Ambrose, three other women were arraigned on a felony fraud count, including 25-year-old Nikiesha McGovern of West Rutland, 30-year-old Crystal Hathaway-Therrien of Bradford and 27-year-old Magen Hill of Perkinsville.
The Eagle Times reported on Hill’s arraignment earlier in the week. McGovern is alleged to have falsified 350 care hours resulting in $2,152 in overpayments by the Vermont Medicaid program while Hathaway-Therrien was the employer-of-record for a minor and filed for 650 hours of labor that was not provided for a total of approximately $6,357 in overpayments, according to court records.
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