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Berkshire
Eagle - False Health Claims Alleged PITTSFIELD
-- A former Pittsfield man and a woman from Tampa, Fla. face arraignment
in Pittsfield next month on charges in connection with allegedly making
false claims to MassHealth, causing the program to pay more than
$300,000 in benefits to which they were not entitled. Michael
Ferdyn, 46, formerly of Pittsfield, now of Tampa, and Jeannie Edwards,
45, of Tampa, are charged with one count each of Medicaid false claims
and larceny by false pretenses. The
pair was indicted by a Berkshire County grand jury on Thursday and will
be arraigned on Monday, April 12, in Berkshire Superior Court. Investigation
began in 2008 The
alleged discrepancies in medical claims were first discovered by the
Bureau of Special Investigations from the office of state Auditor A.
Joseph DeNucci. The matter was then referred to Attorney General Martha
Coakley's office, which began an investigation of the couple's
activities in 2008. According
to an incident report, while living in Massachusetts, Ferdyn, a
quadriplegic, received legitimate assistance through the MassHealth
Personal Care Attendant (PCA) program, a benefit designed to allow
people with long-term disabilities to live independently at home. Through
the program, eligible MassHealth members are given funds and authority
to hire and supervise a personal care attendant to help with activities
of daily living such as bathing, eating, toileting and moving about
inside the home. PCA
program fast-growing A
spokesman from the state auditor's office said that the PCA program is a
fast-growing one in Massachusetts, recently accounting for an estimated
$330 million in Medicaid expenditures and serving approximately 16,000
individuals. "The
intent is a good one, to allow people to remain in their homes. The
problem that the Bureau of Special Investigations has found is [the
program] is vulnerable to fraud and abuse," said Glenn Briere,
spokesman for DeNucci's office. According
to the attorney general, Ferdyn permanently moved to Florida in December
2003 to reconnect with Edwards, a former girlfriend. The attorney
general's office said Ferdyn kept his Pittsfield address and was not
eligible to receive PCA services under the Medicaid plan in Florida. So
he allegedly continued to submit claims to MassHealth for PCA services
being provided by Edwards. Edwards
worked full time as the director of nursing at a Florida nursing and
rehabilitation facility from July 2004 until the end of May 2005. She
and Ferdyn reportedly submitted claims to the MassHealth PCA program for
dates and times when Edwards was working at this facility. Authorities
further allege that from January 2004 through December 2009, both Ferdyn
and Edwards made false statements to MassHealth, stating that Edwards
was providing PCA services for Ferdyn at his Pittsfield residence. MassHealth
requires that all members submit annual applications to determine if
they qualify for benefits such as the PCA program; one of the
requirements of eligibility is proof of residence. Authorities
allege that Ferdyn submitted eligibility forms to MassHealth on an
annual basis between 2003 and 2009. In all submissions, Ferdyn
fraudulently listed his residency as Massachusetts, while he was
actually living in Florida. Despite
the fact MassHealth requires annual eligibility reviews, authorities say
that for five years, both Edwards and Ferdyn completed and signed
fraudulent timesheets every two weeks and submitted them to MassHealth
for payment, allowing Edwards to receive more than $300,000 for PCA
services she reportedly gave to Ferdyn. The case is being prosecuted by Massachusetts Assistant Attorney General Nancy Maroney and was investigated by Meaghan Fogaren, both of Attorney General Martha Coakley's Medicaid Fraud Division. The Massachusetts Bureau of Special Investigations of the Office of the State Auditor, the Boston office of the U.S. Department of Health and Human Services Office of Inspector General, and the Florida Attorney General's Medicaid Fraud Control Unit also assisted with the investigation. |
| Mailing Address:oseph DeNucci
P.O. Box 600252 Newton MA 02460 Office Location: 259 Walnut St Newton, MA 02460 Phone: 617.630.0600 Fax: 617.630.0625 E-Mail: HDQ@JoeDeNucci.com |
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