Holyoke Woman Pleads Guilty To Health Care Fraud

BOSTON - A Holyoke resident pleaded guilty today in U.S. District Court in Springfield to defrauding MassHealth by billing for personal care attendant services that were never provided.

Miosottis Gonzalez, 25, pleaded guilty to conspiracy to commit health care fraud. Three other individuals involved in the conspiracy, including Gonzalez’s aunt and uncle, previously pleaded guilty and were sentenced earlier this month.

Gonzalez engaged in a scheme to defraud the state’s Personal Care Attendant (PCA) Program, which is funded by MassHealth, the Commonwealth’s Medicaid Program, and assists individuals with permanent or chronic disabilities to keep their independence, stay in the community and manage their own personal care. The disabled individual is responsible for recruiting, hiring, scheduling, training, and, if necessary, firing his or her PCA and track the work performed by the PCA on bi-weekly time sheets.

Gonzalez recruited friends to provide identification documents which were used to bill MassHealth for PCA services that were never provided. She also signed and submitted false time sheets in her own name to obtain payment for services she never provided.

United States Attorney Carmen M. Ortiz and Susan J. Waddell, Special Agent in Charge of the Department of Health and Human Services, Office of Inspector General (HHS-OIG) made the announcement today. The case was investigated by HHS-OIG with the assistance of the Massachusetts Auditor’s Office, Bureau of Special Investigations, and the Massachusetts Office of the Attorney General, Medicaid Fraud Division. The case is being prosecuted by Assistant U.S. Attorney Karen L. Goodwin, of Ortiz’s Springfield branch office.