FOR IMMEDIATE RELEASE
(Rocky Hill, CT) - A New Haven woman has been sentenced in Harford Superior Court for submitting fraudulent claims to Medicaid for services that were not provided, as well as for stealing the identity of Medicaid recipients in order to submit the fraudulent claims.
The Honorable David P. Gold on June 6, 2024 sentenced Ethel Bethea, age 61, to seven years in prison, execution suspended after one year served and five years of probation. The defendant was order to pay $38,000 by June 10, 2024, with the remaining $63,408.97 to be paid during probation, for a total in restitution of $101,408.97. She was also ordered not to act as a Medicaid provider or provide services to any Medicaid recipient, substance abuse evaluation and treatment if deemed necessary, gambling abuse evaluation and treatment if deemed necessary, and any alternative to incarceration services deemed necessary upon her release.
By being found guilty of a program-related felony, the defendant is also subject to mandatory exclusion as a health care provider to certain federally funded health programs pursuant to federal and state laws and regulations. Medicaid is a government program that provides health coverage to low-income, disabled, and elderly individuals, and is financed by both the federal and state governments.
Bethea pleaded guilty under the provisions of the Alford Doctrine and was convicted of Larceny in the First Degree by Defrauding a Public Community, in violation of Connecticut General Statutes § 53a-122(a)(3) (formerly §53a-122(a)(4)), Health Insurance Fraud, in violation of Connecticut General Statutes § 53-442, and Identity Theft in the Third Degree, in violation of Connecticut General Statutes § 53a-129d, Larceny in the First Degree and Health Insurance Fraud are both class B felonies. Identity Theft in the Third Degree is a class D felony.
An investigation led by the Medicaid Fraud Control Unit in the Office of the Chief State’s Attorney, with the assistance of the U.S. Department of Health and Human Services, and the Connecticut Attorney General’s Office determined that in September 2018, Bethea was approved by the Connecticut Department of Social Services (DSS) to be a Connecticut Medical Assistance Provider (CMAP). The type of services Bethea could provide were as a Behavioral Health Clinician and the specialty was a Licensed Certified Alcohol and Drug Counselor. Bethea operated her own business, Ethel Bethea Counseling.
Medicaid Fraud Control Unit Inspectors determined that between September 2018 and October 2019, Bethea submitted hundreds of claims for services she claimed to have provided that were not delivered. Bethea used the Medicaid identification numbers of numerous individuals, without their consent or knowledge, in order to submit the fraudulent claims and obtain $101,408.97 for these false billings. Additionally, Bethea, who claimed to have no income, enrolled as a Medicaid recipient and received personal medical services paid for by Medicaid.
The case was prosecuted by the Connecticut 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 U.S Department of Health and Human Services, the Office of the Attorney General, and the New Haven 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 $2,988,308.00 for the fiscal year of October 1, 2023 through September 30, 2024. The remaining 25 percent, totaling $996,099.00 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.