Caregiver Found Guilty Of Defrauding Medicaid Program In Morris Co.

MORRIS COUNTY, NJ — A caregiver was sentenced after being found guilty of defrauding New Jersey Medicaid, alleging she was caring for a Morris County man when, according to prosecutors, she was actually in Michigan.

Michael Ann Ellis, 62, of Flint, Michigan, was found guilty on all counts of health care claims fraud, Medicaid fraud and theft by deception, Attorney General Matthew J. Platkin said on Wednesday.

The guilty verdict came after a four-day jury trial in Morris County before Superior Court Judge Claudia Jones. Ellis is detained pending sentencing, facing up to 10 years in New Jersey State Prison and a fine of up to $150,000.

Prosecutors said that Ellis submitted false timesheets to Medicaid between 2016 and 2020, claiming she was caring for an ex-boyfriend who had suffered a stroke.

The investigation into Ellis began with a referral to the Office of the Insurance Fraud Prosecutor—Medicaid Fraud Control Unit (OIFP-MFCU) in June 2020 from Morris County Adult Protective Services (APS), officials said.

Ellis was enrolled in Medicaid's "Personal Preference Program," which permits her to receive up to 56 hours of care per week, according to the report. However, the jury heard evidence that Ellis was working as a substitute teacher in Michigan on the same dates she was billing for services in New Jersey.

"This was corroborated by witness testimony from a superintendent from one of the Michigan schools, along with timesheets and payroll records with school locations, dates, and hours of substitute teaching duties Ellis performed in Michigan," the Office of the Insurance Fraud Prosecutor said.

Additionally, Ellis' bank records revealed a slew of transactions in Michigan on or around the time Ellis was substitute teaching.

Ellis submitted false timesheets for 361 dates of service (about 3,227 hours) between Jan. 6, 2016, and April 13, 2020, and was paid nearly $45,000 by the Medicaid Program for services never delivered.

At the time of sentencing, the state said they were seeking reparation.

“Flagrant abuse of programs available through Medicaid, like the Personal Preference Program, that were developed to support our citizens in need of care, will not be tolerated,” said Attorney General Platkin. “The defendant thought she could get away with billing for care in New Jersey when she was in another state. If you think you are not going to get caught, you are wrong.”