New Haven Woman, 61, Gets 7 Years In Prison For Medicaid Fraud: State

NEW HAVEN, CT —A New Haven woman was sentenced to seven years in prison for Medicaid fraud, according to state officials.

Ethel Bethea, 61, pleaded guilty to 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, according to 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.

Bethea's seven-year sentence will be suspended after one year served and five years of probation, officials said. She was ordered 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, per prosecutors. Bethea was also ordered to "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, according to the Office of the Chief State’s Attorney. 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 first-degree larceny by defrauding a public community, health insurance fraud, and third-degree identity theft.

An investigation found that in September 2018, Bethea was approved by the Connecticut Department of Social Services to be a Connecticut Medical Assistance Provider. 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, officials said. 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, per prosecutors. Additionally, Bethea, who claimed to have no income, enrolled as a Medicaid recipient and received personal medical services paid for by Medicaid, according to state authorities.

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," a news release reads.

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.