CLARION CO., Pa. (EYT) — A man who committed medical assistance fraud by billing and receiving $99,464.55 for services not rendered was sentenced to house arrest on Wednesday.
On Wednesday, February 5, President Judge Sara J. Seidle-Patton sentenced 58-year-old Robert E. Kinzey Jr., of Mayport, to a total of four to eight years of house arrest with electronic monitoring.
Kinzey was ordered to a minimum of 24 months to a maximum of 48 months of house arrest on each of the following charges, with the sentences to run consecutively:
– False/Fraud Med Assist Claim, Felony 3
– Conspiracy — Unentitled Reimbursement, Felony 3
Kinzey was also ordered to pay restitution in the amount of $99,465.65 jointly with co-defendant James Aloyus Kinzey.
Court documents indicate Robert Kinzey pleaded guilty to the above charges on December 18, 2019.
As a result of the plea agreement, one third-degree felony count of theft by deception-false impression was dismissed.
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.
Robert Kinzey and James Kinzey were arraigned on July 17 in Magisterial District Judge Jeffrey C. Miller’s office.
According to court documents, President Judge Sara J. Seidle-Patton sentenced 29-year-old James Aloyus Kinzey, of Clarion, to a total of two years of probation on January 22, 2020, on each of the following charges, with the sentences to run concurrently:
– False/Fraud Medical Assistance Claim, Felony 3
– Conspiracy — Unentitled Reimbursement, Felony 3
Court documents indicate James Kinzey pleaded guilty to the above charges on December 18, 2019.
As a result of the plea agreement, one third-degree felony count of theft by deception-false impression was dismissed.
