Miosottis Gonzalez, Defrauding MassHealth, Massachusetts 2023

BOSTON – A brazen scheme to defraud MassHealth, the Commonwealth’s Medicaid Program, has come to an end for a Holyoke woman. Miosottis Gonzalez, 25, has been sentenced to two years of probation and ordered to pay $64,000 in restitution for her role in defrauding the state’s Personal Care Attendant (PCA) Program.

According to court documents, Gonzalez engaged in a scheme to bill MassHealth for PCA services that were never provided. She recruited friends to provide identification documents, which were then used to bill the program for services that never occurred. Gonzalez also signed and submitted false time sheets in her own name to obtain payment for services she never provided.

The PCA Program, funded by MassHealth, helps individuals with permanent or chronic disabilities keep their independence, stay in the community, and manage their own personal care. But Gonzalez’s scheme targeted this vulnerable population, exploiting the system for her own gain.

Three other individuals involved in the conspiracy, including Gonzalez’s aunt and uncle, previously pleaded guilty and were sentenced earlier this month. The case was investigated by the Department of Health and Human Services, Office of Inspector General, with the assistance of the Commonwealth of Massachusetts Auditor’s Office, Bureau of Special Investigations, and the Commonwealth of Massachusetts, Office of the Attorney General, Medicaid Fraud Division.

“This case highlights the importance of protecting our most vulnerable citizens from exploitation,” said United States Attorney Carmen M. Ortiz. “We will continue to work tirelessly to ensure that those who seek to defraud our healthcare system are held accountable.”

Susan J. Waddell, Special Agent in Charge of the Department of Health and Human Services, Office of Inspector General, added, “The Office of Inspector General is committed to preventing and detecting healthcare fraud. We appreciate the efforts of our law enforcement partners in bringing this case to a successful resolution.”

Gonzalez pleaded guilty to conspiracy to commit health care fraud in April and will now face the consequences of her actions. Her sentence serves as a reminder that those who seek to defraud the system will be held accountable.

Assistant U.S. Attorney Karen L. Goodwin of Ortiz’s Springfield Branch Office prosecuted the case.

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