Former PCA pleaded guilty to defrauding $63K from MassHealth

James Lynch was sentenced to 5 years probation

NORTHAMPTON, Mass. (WWLP) – A former Personal Care Attendant from Agawam pleaded guilty to stealing close to $63,000 from MassHealth for services that were not provided.

Attorney General Martha Coakley announced Monday that 45-year-old James Lynch pleaded guilty in Hampshire Superior Court to 1 count of Medicaid False Claims and 1 count of Larceny over $250.

“This man conducted a scheme that charged the state Medicaid program for hours in care and services that was never provided,” AG Coakley said. “Our office is committed to holding accountable those who take advantage of MassHealth, which many people rely on for critical health care coverage.”

Lynch was sentenced to 5 years of probation by the Superior Court Judge C. Jeffrey Kinder. As a condition to his probation, Lynch can not be involved in the PCA program in any capacity, and pay more than $63,000 in restitution.

According to authorities, Lynch submitted false time sheets to MassHealth indicating care for a patient while he was working as a bus driver at the Lower Pioneer Valley Educational Collaborative.

It is also alleged that Lynch had an agreement with the MassHealth member to inflate his timesheets and pay half of his checks to the member.

Jillian Fennimore of the A.G. office said, Holly-Beth Riopel was indicted on the same charges, alleging she billed MassHealth for $44,000 in services to the MassHealth member’s daughter from 2006 to 2008 that were not provided. Riopel is due back in court on April 17 for a pretrial conference.

The case is being prosecuted by Assistant Attorney General Angela Neal and was investigated by Investigator Scott Grannemann, both of Attorney General Martha Coakley’s Medicaid Fraud Division. The case was in collaboration with investigators from the Bureau of Special Investigations of the Office of the State Auditor and the Boston office of the U.S. Department of Health and Human Services Office of Inspector General.