New Britain Woman Charged in Scheme to Defraud Medicaid

A New Britain woman was arrested today and charged with bilking the Medicaid program for thousands of dollars by collecting wages supposedly paid to a man she claimed was providing her care when he was actually in jail.

HELEN SIMONS, age 59, of Westover Road, New Britain, was arrested by Inspectors from the Medicaid Fraud Control Unit in the Office of the Chief State’s Attorney and charged with one count each of Larceny in the First Degree By Defrauding A Public Community, Health Insurance Fraud and First Degree Identity Theft.

According to the arrest warrant affidavit, Simons participated in the Personal Care Assistance (PCA) program, a federal and state funded Medicaid program that allows participants to hire others to assist with their daily care.

Between February 2017 and January 2019, Simons billed Medicaid and collected payments issued to a man who was actually in the custody of the Department of Correction and therefore could not have performed the work, the warrant states.

The alleged scheme unraveled when the man was released from prison and applied for state benefits, but was denied due to reported income from Medicaid, the warrant states. Subsequent investigation by the Medicaid Fraud Control Unit revealed that Simons submitted time sheets in the man’s name without his knowledge and diverted the bogus earnings to her bank account, the warrant states. She was paid about $27,748 for these false claims.

Simons was released after posting a $50,000 non-surety bond and is scheduled to appear in Hartford Superior Court, G.A. No. 14, on August 13, 2019. 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 and First Degree Identity Theft are class B felonies punishable by up to 20 years in prison. Health Insurance Fraud is an unclassified felony punishable by up to 5 years in prison.

The case will be prosecuted by the Medicaid Fraud Control Unit. The unit is grateful for the assistance it received in this investigation from the state Department of Social Services Office of Quality Assurance, Department of Correction and the New Britain Police Department.