State Auditor’s Office uncovers more than $1-million in MassHealth fraud

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MassHealth fraud involving personal care attendants is the rise in Massachusetts, according to a new report from State Auditor Suzanne Bump’s Office. 

MassHealth members with permanent or chronic disabilities can hire personal care attendants, or PCAs, to help them take care of themselves on a daily basis. 

The report found a majority of PCAs who defrauded MassHealth had billed the service for patients, they were no longer working for.

In other cases, PCAs failed to report their income to the Department of Transitional Assistance, or were paid for services to MassHealth members, that they never actually provided.

According to the State Auditor’s Office, the number of incidents of MassHealth PCA fraud has more than doubled over the past three years, growing from 147 cases in 2016, to 300 cases in 2018, totaling $1,379,493.93 in fraud.

That’s just a fraction of the total amount of public benefits fraud. In 2018 alone, Bump’s office investigated 922 cases, resulting in $14.4 million in fraud.

A majority of that fraud, more than 60-percent, involved the state’s MassHealth program.

Here in western Massachusetts, a Springfield resident was recently ordered to repay $59,000 in restitution, after pleading guilty to fraudulently collecting child care vouchers and Supplemental Nutrition Assistance Program (SNAP) benefits. 

Auditor Bump released the following statement: 

“Personal care attendants help people with disabilities maintain their independence and remain in their community. However, our work has shown that this is a public benefit that is unfortunately all-too-frequently ripe for fraud and abuse,” Bump said of the annual report. “Using our powerful data analytic tools and strategic partnerships with other state and local government entities, my office is committed to focusing our efforts in this area to provide taxpayers with confidence that these benefits are reaching the individuals for whom they are intended.”

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