North Haven woman facing Medicaid fraud charges opening Cheshire restaurant in former Waverly Inn [Journal Inquirer, Manchester, Conn.] - Insurance News | InsuranceNewsNet

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May 9, 2024 Newswires
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North Haven woman facing Medicaid fraud charges opening Cheshire restaurant in former Waverly Inn [Journal Inquirer, Manchester, Conn.]

Journal Inquirer (Manchester, CT)

May 9—CHESHIRE — A North Haven woman who plans to open an Italian restaurant in the former Waverly Inn is facing Medicaid fraud charges stemming from her ownership of a home health agency, according to court documents.

Evgieni Baca, also known as Gina Baca, owned and operated Lean On Us Home Care from February 2019 to February 2021. The company was licensed to provide homemaker, companion and personal care assistant services under the Connecticut Home Care Program.

Baca, 41, was arrested in February by inspectors from the Medicaid Fraud Control Unit in the office of the Chief State's Attorney and charged with one count of health insurance fraud and one count of first-degree larceny by defrauding a public community.

Baca has yet to enter a plea in the case and is due back in Meriden Superior Court on June 6. In the meantime, construction is ongoing to open Il Gusto Restaurant and Wine Bar in the Cheshire landmark Waverly Inn building on Maple Avenue.

Reached for comment Wednesday, Baca referred questions to her attorney Jonathan Einhorn.

"There's no merit to these charges that are based upon technical claim violations," Einhorn said. "We intend to win in court."

According to the arrest warrant, an investigation showed Lean On Us Home Care personnel files did not include completed job applications, photocopies of driver licenses, results of criminal background checks, subjects who had criminal convictions that were not revealed to clients, or proof of mandatory training for the personal care assistant workers.

"PCAs are required to have training to provide high-quality, person-centered care to safeguard the health and welfare of older and disabled adults," the warrant states.

In one instance, an employee who was previously arrested on charges of stealing from a client while working at a different agency was assigned to a Lean On Us client. The client's family reported the same employee stole from their mother. According to the warrant, the employee was assigned to another client and not fired. Guilford Police investigated the family's claim and arrested the employee in 2021.

Baca also submitted fraudulent billing for Lean On Us services, the warrant said. Baca received $145,705 in payments from the Connecticut Medicaid Program by submitting billings that contained false, deceptive and/or misleading information, the warrant stated.

Multiple former employees and clients were interviewed throughout the investigation, according to the warrant. Investigators also found that Baca was a Medicaid recipient, as were her two children, and may have falsified income documentation to receive more than $100,000 in medical benefits, the warrant states. Investigators referred the matter to state Department of Social Services fraud unit to investigate and possibly levy additional charges, according to the warrant.

The investigation also revealed Lean On Us received over $49,000 in federal funds via a Paycheck Protection Program loan, the warrant said. In its application, Lean On Us told the Small Business Administration that 37 jobs would be retained because of the PPP loan.

"However according to the payroll records provided by Lean On Us, it shows they did not have over 30 employees on the payroll at any time," according to the warrant. Investigators planned to forward the evidence regarding the PPP loan to the Small Business Administration, the warrant stated.

Investigators will also refer evidence to the state Department of Revenue Services as well as the federal Internal Revenue Service for analysis of the company's payroll tax and wage information, the warrant stated.

The case is being prosecuted by the Medicaid Fraud Control Unit. The unit received assistance in the investigation from the state Department of Social Services, Office of Quality Assurance and the Meriden Police Department.

Health insurance fraud and larceny in the first degree by defrauding a public community are class B felonies punishable by up to 20 years in prison, according to the state's attorney's office.

___

(c)2024 Journal Inquirer, Manchester, Conn.

Visit Journal Inquirer, Manchester, Conn. at www.journalinquirer.com

Distributed by Tribune Content Agency, LLC.

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