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Four Individuals Charged With Medicaid Fraud Related To In Home/Community-Based And Personal Care Services That Were Not Provided

CONTACT: Ed Baker, Assistant Attorney General, (802) 828-5511

March 26, 2014

Four individuals enrolled as either caregivers or employers-of-record in Vermont’s Medicaid-funded Home and Community Based (HCBS) or Personal Care programs were separately arraigned yesterday in Vermont Superior Court for Windsor County on felony counts of Medicaid Fraud for allegedly billing for care to children and vulnerable adults that was not provided. Collectively, these individuals are alleged to have submitted thirty-four fraudulent timesheets for almost two thousand hours of care that was not rendered, resulting in overpayments by the Vermont Medicaid program of approximately $18,000.

Theresa Ambrose, age 55, of Springfield, Vermont, was arraigned on one felony count of Medicaid Fraud. According to court documents, Ms. Ambrose was employed as the caregiver for a vulnerable adult enrolled in the Choices for Care Medicaid program. She is alleged to have submitted seven timesheets purporting to have provided 512 hours of care on days when she purported to have worked 24 hours per day, factoring in time spent at another job, including five days in a row. The timesheets resulted in at least $4,600 in overpayments by the Vermont Medicaid program.

Nikiesha McGovern, age 25, of West Rutland, Vermont, was arraigned on one felony count of Medicaid Fraud and one felony count of False Pretense. According to court documents, Ms. McGovern was employed as the caregiver to a minor child with special needs enrolled in the Children’s Personal Care Services Medicaid program. She is alleged to have submitted six timesheets purporting to have provided 350 hours of care when the child was actually in someone else’s care. These timesheets resulted in $2,152 in overpayments by the Vermont Medicaid program.

Magen Hill, age 27, of Perkinsville, Vermont, was arraigned on one felony count of Medicaid Fraud. According to court documents, Ms. Hill was employed as the caregiver to a vulnerable adult suffering from a serious medical condition who was enrolled in the Choices for Care Medicaid program and also on hospice care. She is alleged to have submitted twelve timesheets purporting to have provided 456 hours of personal and respite care that was not actually provided. These timesheets resulted in approximately $4,485 in overpayments by the Vermont Medicaid program.

Crystal Hathaway-Therrien, age 30, of Bradford, Vermont, was arraigned on one felony count of Medicaid Fraud and one felony count of False Pretense. According to court documents, Ms. Hathaway-Therrien was the employer-of-record for a minor child enrolled in the Children’s Personal Care Services Medicaid program. She is alleged to have submitted nine timesheets purporting to have provided 650 hours of personal care that was not actually provided, and forged the signature of the caregiver. The timesheets resulted in approximately $6,357 in overpayments by the Vermont Medicaid program.

In each case above, the court imposed conditions of release governing the defendants’ conduct while the cases are pending. Each Medicaid Fraud felony charge carries a maximum penalty of up to ten years imprisonment and/or fines equal to twice the amount of payments wrongfully obtained. These cases are being prosecuted by the Medicaid Fraud & Residential Abuse Unit within the Vermont Attorney General’s Office, with assistance from the U.S. Department of Health and Human Services, Office of the Inspector General.

  Website consulting provided by The National Association of Attorneys General.