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Clarion County Father, Son Receive Nearly $100k for Medical Assistance Services Not Rendered

Monday, July 22, 2019 @ 12:07 AM

Posted by Joanne Bauer

police - new 6/17/2019
REDBANK TWP., Pa. (EYT) – A Clarion County father and son are facing medical assistance fraud charges for billing and receiving $99,464.55 for services not rendered.

According to court documents, the Office of Attorney General filed criminal charges against 58-year-old Robert E. Kinzey Jr., of Mayport, and 28-year-old James Aloyus Kinzey, of Clarion, on Wednesday, July 17, 2019.

The charges stem from an investigation involving fraudulent claims submitted to the Department of Human Services (DHS) through the Medical Assistance (MA) Program. On August 6, 2018, the Pennsylvania Office of Attorney General (OAG) Medicaid Fraud Control Section (MFCS) opened the case. The allegation was provided by a citizen informant.

OAG Begins Medical Assistance Fraud Investigation

According to a criminal complaint, the original investigation indicated that James Kinzey allegedly provided approximately six hours of personal care services for Robert E. Kinney, Jr. at Robert Kinzey’s residence located at a residence on Route 28, in Mayport, Redbank Township, Clarion County.

Over the course of the investigation, Agent Edward Porada, of the PA OAG, received correspondence showing that J. Kinzey was in medical facilities at least eight times and was unable to render personal care services for R.Kinzey; however, during these times, R. Kinzey submitted timesheets and J. Kinzey was compensated for the services that he claimed he provided, the complaint states.

According to the complaint, during an interview with OAG agents, R. Kinzey admitted that he submitted timesheets while J. Kinzey was in medical facilities and was not at the residence during those times. R. Kinzey also stated that J. Kinsey was aware that he was submitting the timesheets and J. Kinzey accepted payment for services that he never performed.

Agents Discover Defendants Split Compensation 50/50

The complaint also indicates that during an interview with OAG agents, J. Kinzey confirmed R. Kinzey’s statements. J. Kinzey admitted that he knew R. Kinzey was submitting the timesheets fraudulently Also, during the interview, J. Kinzey admitted to OAG agents that from the time he started working for R. Kinzey, on or about February 8, 2014, he only provided personal care services for R. Kinzey for 12 hours a week but billed for at least 40 or more hours. J. Kinzey also admitted that R. Kinzey would intentionally submit the fraudulent timesheets knowing that J. Kinzey provided only 12 hours of services weekly. J. Kinzey also admitted that he and R. Kinzey would split his paychecks 50/50.

OAG agents re-interviewed R. Kinzey who confirmed J. Kinzey’s statements.

Agents Learn J. Kinsey Received Nearly $100K for Services Not Rendered

According to the complaint, through further investigation, it was confirmed that the timesheets were submitted and checks were received during the timeframe from February 8, 2014, through February 17, 2019. Checks were submitted electronically to an account operated by J. Kinzey. During this timeframe, J. Kinzey and R. Kinzey submitted a total of 8,182 hours for personal care serves not rendered.

In total, J. Kinzey received $99,464.55 for services not rendered. Medicaid was billed a total of $126,157.56 from the care organizations for these services.

Defendants Arraigned, Released on ROR, Awaiting Preliminary Hearings

Robert Kinzey and James Kinzey were arraigned on July 17 in Magisterial District Judge Jeffrey C. Miller’s office on the following charges:

– False/Fraud Med Assist Claim, Felony 3
– Unentitled Reimbursement, Felony 3
– Theft By Deception-False Impression, Felony 3

Both men were released on their own recognizance.

Preliminary hearings are scheduled for 1:15 p.m. on August 6 with Judge Miller presiding.

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