A group of people are stealing from all of us who pay taxes. This scam is pretty low - they're using sick family members to cash in. But Rochester has its own state-run Medicaid fraud division that investigates these types of cases and they are throwing the book at fraud thieves.
A group of people are stealing from all of us who pay taxes. This scam is pretty low - they're using sick family members to cash in.
When it's used the right way, the Medicaid funded, Consumer Directed Personal Assistance Program allows a person to choose an in-home caregiver. Many times that could be a friend or family member. The caregiver fills out a time sheet and is paid anywhere from $11 to $15 an hour to provide services, and the patient signs off on it. The freedom opens the door to allow the caregiver to lie about the time they are working.
That's what happened in 58-year-old Michael Cooper's case. He's from Rochester and was on probation. Authorities say he was logging time taking care of a loved one when he was actually with his probation officer.
Rochester has its own state-run Medicaid fraud division that investigates these types of cases. Director Catherine Wagner says these criminals threaten the integrity of the program.
"It's a place where it could be ripe for fraud," Wagner said. "If you hire someone to take care of you or someone else on your behalf hires someone and it's someone who is well known to you then you might be more likely to let them get away with not working all their hours or letting them submit false claims."
Margret Jones, Special Assistant for the Rochester Medicaid Fraud Division, often prosecutes these types of cases throughout the area. She says the thieves are abusing a great program.
"Everything can threaten it when people start to lose sight of what the program is for," Jones said. "The downside to pursuing these prosecutions is the chilling effect on legislation and the community."
Cooper was sentenced to 90 days in jail and he'll have to pay back the $1,170 dollars he stole from Medicaid. To give you an idea of how common this is, there's another person in court for this same thing later today. She's accused of stealing money the same way Cooper did, but she allegedly stole more than $6,000.
If you suspect someone is abusing the program, you can report it to the state here.