02/18/2020
New Haven Woman Charged with Medicaid Fraud
A New Haven woman is charged with cheating the Medicaid program out of thousands of dollars by filing bogus claims including billing the government health program for services to patients who were deceased or in the hospital or jail.
ETHEL R. BETHEA, age 56, of Rosette Street in New Haven, is also accused of declaring that she had no income and collecting Medicaid benefits for herself when she was, in fact, billing the program for services she claimed to provide to others.
Bethea was arrested Tuesday by Inspectors from the Medicaid Fraud Control Unit (MFCU) in the Office of the Chief State’s Attorney on a warrant charging her with one count each of Larceny in the First Degree By Defrauding A Public Community and Health Insurance Fraud, and fifteen counts of Identity Theft in the Third Degree.
According to the arrest warrant affidavit, Bethea, a previously convicted felon who is a licensed drug and alcohol counselor, was enrolled as a provider in the Connecticut Medical Assistance Program (CMAP). An audit by the Department of Social Services (DSS), which administers the state’s Medicaid program, found numerous billing irregularities which were reported to the MFCU for additional investigation.
The investigation found that Bethea billed Medicaid for 10 patients who were hospitalized at the time she claimed to be counseling them in her office, for a patient who had died in a motor vehicle accident and another patient who was in jail on the dates she allegedly provided counseling.
The warrant also cites claims for people who could not even identify a photograph of Bethea and billings for services she claimed to have provided when she was actually on a cruise ship to the Bahamas. The disputed claims totaled more than $101,000 over an 11-month period, the warrant states.
Additionally, Bethea, who claimed to have no income, enrolled as a Medicaid recipient and received more than $13,000 in personal medical services paid for by Medicaid.
Bethea was released on a $150,000 bond and is scheduled to appear in Hartford Superior Court, G.A. No. 14, on March 6, 2020. The charges are merely accusations and she is presumed innocent until and unless proven guilty.
Larceny in the First Degree By Defrauding A Public Community is a class B felony punishable by up to 20 years in prison. Identity Theft in the Third Degree is a class D felony punishable by up to 5 years in prison. Health Insurance Fraud is an unclassified felony punishable by up to 5 years in prison.
The case will prosecuted by the MFCU. The Unit is grateful for the assistance it received in this investigation from the state Department of Social Services Office of Quality Assurance, the U.S. Department of Health and Human Services, the Office of the Attorney General and the New Haven Police Department.