A New York woman was arrested today and charged with fraudulently billing the government’s Medicaid health insurance program for providing at-home care to a patient who was actually in the hospital or a nursing home.
Nicole Bologh, age 52, of Rome, New York, 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 and Health Insurance Fraud. Acting on an arrest warrant that was issued in December 2018, the Rome (New York) Police Department took Bologh into custody. She waived extradition and authorities brought her to Connecticut.
According to the arrest warrant affidavit, between January 2014 and April 2016, Bologh submitted numerous fraudulent billings claiming that she had rendered in-home care for a disabled client who was actually admitted to either a hospital or nursing home at the time. Bologh was paid about $2,760.00 for the fraudulent claims.
Bologh was employed under the Personal Care Assistance (PCA) program, which is a federal and state-funded Medicaid program that provides funds to allow disabled adults to hire assistants for daily care, thus enabling the individual to remain at home instead of being placed in a health care facility.
The alleged scheme unraveled when the Connecticut Department of Social Services, which administers the state’s PCA contracts, uncovered evidence that the disabled client was not living at home for some periods of time that were billed and therefore was ineligible for PCA services.
Bond on the warrant was set at $10,000. Bologh is scheduled to appear in Hartford Superior Court, G.A. No. 14, on March 2, 2021. 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. Health Insurance Fraud is an unclassified felony punishable by up to 5 years in prison.
The case will 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, the Rome (New York) Police Department and the New Britain Police Department.