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03/13/2024

Rocky Hill Woman Charged with Filing Fraudulent Medicaid Claims

FOR IMMEDIATE RELEASE

 

(Rocky Hill, CT) - A Rocky Hill woman was arrested today and charged with submitting fraudulent claims to Medicaid.

Saruka S. Prima, age 33, of Rocky Hill, was arrested today by Inspectors from the Medicaid Fraud Control Unit in the Office of the Chief State's Attorney and charged with one count of Larceny in the First Degree By Defrauding A Public Community in violation of Connecticut General Statutes § 53a-122(a)(3), one count of Health Insurance Fraud in violation of Connecticut General Statutes § 53-442, and two counts of Identity Theft in the First Degree in violation of Connecticut General Statutes § 53a-129b.

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 funds 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 health care 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 information 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 and is scheduled to appear in New Britain Superior Court, G.A. No. 15, on March 26, 2024. The charges are merely accusations and she is presumed innocent until and unless proven guilty.

The case will prosecuted by the Medicaid Fraud Control Unit. The Unit is grateful for the assistance it received in this investigation from the Connecticut Department of Social Services, Office of Quality Assurance - Special Investigations Division, and the New Britain Police Department.

The Connecticut Medicaid Fraud Control Unit receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $2,988,308 for the fiscal year of October 1, 2023 through September 30, 2024. The remaining 25 percent, totaling $996,099 for the same fiscal year, is funded by the State of Connecticut.

Anyone with knowledge of suspected fraud or abuse in the public healthcare system is asked to contact the Medicaid Fraud Control Unit at the Office of the Chief State’s Attorney at (860) 258-5986.