Crime

Is it possible to be in two places at once? This fraud case rests on its unlikeliness

A Lexington woman who was paid $45,000 for the personal care services of a mentally disabled patient now faces felony charges after she allegedly submitted false time sheets.

Amy Sue Rector, 40, was indicted by a Fayette County grand jury earlier this summer on charges of felony theft of more than $10,000 and devising or engaging in a scheme to defraud the Kentucky Medical Assistance Program of $300 or more.

From Dec. 19, 2013, through Aug. 18, 2015, Rector “knowingly signed time sheets which were submitted to Blue Grass Area Development District for time she did not actually work,” according to court documents filed in the criminal case.

Exhibits in the court file indicate that Rector was to provide personal care services through a “consumer-directed option” program that allows patients to receive care at home rather than in an institutional setting.

Time sheets that Rector submitted conflict with Facebook vacation posts, medical appointment records, surveillance, and statements from two witnesses. They all indicate that Rector was elsewhere, according to court documents.

Rector, through her attorney, Eric Ray, had no comment on the case Tuesday.

Ashley Morgan, assistant attorney general with the Medicaid Fraud and Abuse Control Unit in Frankfort, also declined to comment on the case.

The state attorney general’s office has offered a plea agreement to Rector, but there is no record in the court file that she has accepted.

The offer was this: In exchange for a guilty plea, the state would agree to dismiss the count of theft of more than $10,000, and the state would recommend that a one-year jail sentence on the fraud charge would be probated for three years so Rector wouldn’t serve time.

However, an additional requirement of the plea agreement is that Rector would pay back the money she is accused of taking.

A status hearing on the case is scheduled Friday before Fayette Circuit Judge Pamela Goodwine.

A 2016 federal report examining Medicaid personal care services across the country found “significant and persistent compliance, payment and fraud vulnerabilities.”

Medicaid is the largest health care program in the United States, with about 73 million people enrolled as of July 2016. It represents one-sixth of the national health care economy. Personal care services fraud takes many forms, but common schemes involve services that were unnecessary or not provided.

“Often fraud involves showing that PCS attendants and providers submitted false documentation of activities,” the report said. “Most fraud cases involving PCS come to the attention of law enforcement only through referrals from individuals who know the people committing the acts.”

In one case in Missouri, a personal care services attendant submitted claims for providing care for four beneficiaries simultaneously while working a full-time job. Her time sheets for more than 130 days indicated that she was in two places at the same time.

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