CT alcohol and drug counselor sentenced for submitting hundreds of fraudulent Medicaid claims

A New Haven alcohol and drug counselor has been sentenced to a year in prison for submitting hundreds of Medicaid claims for services that were never delivered using identification numbers of numerous individuals without their knowledge to fraudulently receive more than $100,000.

Ethel Bethea, 61, was handed down the sentence Thursday in Hartford Superior Court, where Judge David P. Gold ordered that she serve five years of probation once she is released from prison, according to the Connecticut Division of Criminal Justice.

While on probation, a violation would expose Bethea to an additional six years behind bars, Gold ordered.

Criminal justice officials said Gold also ordered her to pay $38,000 of restitution by Monday, with the remaining $63,408 to be paid while she serves probation. In total, she has been ordered to pay $101,408 of restitution .

Bethea was also ordered not to act as a Medicaid provider or provide services to any Medicaid recipient, criminal justice officials said.

Prior to sentencing, Bethea pleaded guilty under the Alford doctrine to first-degree larceny by defrauding a public community, health insurance fraud and third-degree identity theft.

By being found guilty of a program-related felony, judicial officials said she 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.”

“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,” the Division of Criminal Justice said in a news release.

In September 2018, Bethea was approved by the Connecticut Department of Social Services to be a Connecticut Medical Assistance Provider, official said. The type of services Bethea could provide were as a Behavioral Health Clinician with a specialty as a Licensed Certified Alcohol and Drug Counselor. She 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. 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 “for these false billings,” judicial officials said.

Additionally, Bethea claimed to have no income and enrolled as a Medicaid recipient, receiving personal medical services paid for by Medicaid, officials said.

The investigation was led by 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.

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.