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Two indicted on charges of defrauding state health plan

Holly Beth Riopel of Palmer and David Lynch of Agawam were both indicted in Hampshire Superior Court on one count of Medicaid false claims and one count of larceny over $250. The case was handled in Hampshire County because one consumer involved resides in the county and because alleged false billing occurred within Hampshire County, according to Massachusetts Attorney General Martha Coakley’s office.

The indictments were part of a larger pool of 32 indictments returned by grand juries in Hampshire, Hampden and Worcester counties this week. They involve charges against five former personal care attendants and three so-called PCA surrogates who allegedly defrauded the state’s Medicaid program of $260,000. The allegations include billing for services while incarcerated, working other jobs, charging for a deceased MassHealth member and other false billing schemes, according to the attorney general’s office.

“MassHealth is a critical program that provides health insurance for some of our most vulnerable residents,” Coakley said in a statement Wednesday. “The brazenness of the fraud committed in these cases is particularly troubling. The defendants allegedly stole more than $260,000 from taxpayers, diverting resources from those who truly need it.”

In the Hampshire County indictments, prosecutors allege Lynch submitted false time sheets to MassHealth indicating care for a patient while he worked as a bus driver. Authorities also allege he had an agreement with a consumer to inflate his time sheets and pay half his checks to the MassHealth care member. In total, Lynch billed MassHealth approximately $63,000 as part of the alleged schemes, according to the AG’s office.

In Riopel’s case, authorities allege she billed MassHealth $44,000 in services from 2006 to 2008 that were not provided.

Lynch and Riopel are to be arraigned at a later date.

In another related case, a Hampden County grand jury returned indictments against a 33-year-old Holyoke woman, Amarilis Pirela, who allegedly billed MassHealth for approximately $20,000 by submitting false time sheets in the name of her brother. Authorities say the services were never provided because during the time the services were billed, Pirela’s brother was incarcerated in Massachusetts for illegal possession of a firearm and ammunition.

Pirela also allegedly billed the state $20,000 worth of services for a Medicaid recipient who had died, according to Coackley’s office.

Dan Crowley can be reached at dcrowley@gazettenet.com.

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