Rocky Hill woman charged with Medicaid fraud - Insurance News | InsuranceNewsNet

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March 22, 2024 Newswires
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Rocky Hill woman charged with Medicaid fraud

Herald, The (New Britain, CT)

ROCKY HILL Hill woman was arrested and charged with submitting fraudulent claims to Medicaid. Saruka S. Prima, 33, of Rocky Hill, was arrested by Inspectors from the Medicaid Fraud Control Unit in the Office of the Chief State's Attorney and chaiged with one count of larceny in the first degree by defrauding a public community, one count of health insurance fraud and two counts of identity theft in the first degree.

According to the arrest warrant affidavit, between April 2019 and July 20, 2023, Prima was the owner of 2 Sisters Inc., a licensed Connecticut Home Care Provider, and 2 Sisters Inc. DBA (doing business as) Global Care Companion and Homemakers, a licensed Personal Care Services provider, which were enrolled in the in the Connecticut Medical Assistance Program (CMAP) to provide personal care, homemaker and companion services. The Personal Care Assistance Waiver (PCA) program, which is a federal and state-funded Medicaid program administered by the Department of Social Services (DSS) that provides fimds to allow elderly and people with disabilities to hire assistants for daily care, thus enabling the individuals to remain at home instead of being placed in a healthcare facility.

The investigation revealed that Prima utilized the personal identifying information of a deceased person and submitted claims to DSS and obtained monies in the amount of $124, 000.20 for services not provided by the deceased person. Prima also utilized the personal identifying information of a past employee to submit claims for payment and obtained monies in the amount of $259, 144.83 for PCA services not provided by the former employee. Prima also submitted claims for services that were not rendered while clients were either hospitalized or in extended care facilities and obtained monies in the amount of totaling $38, 594.02.

The money profited by Prima totaling $421, 739.05 constitutes the crime of larceny in the first degree by defrauding a public community. The submission of these claims to the Department of Social Services by Prima containing false, incomplete, deceptive or misleading infonnation constitutes the crime of Health Insurance Fraud. The fraudulent use of the identities of two individuals, one deceased and one no longer employed by the defendant, constitutes the crime of identity theft. Larceny in the first degree by defrauding a public community, health insurance fraud and identity theft in the first degree are all classified as B felonies and punishable by up to 20 years in prison. Prima was released on a $250, 000.00 non-surety bond.

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