Attorney General Peter F. Kilmartin announced that Priscilla Pascale (age 54), of Barrington, was charged with five counts of Medicaid fraud and five counts of conspiracy to commit Medicaid fraud. Ms. Pascale is the owner and operator of St. Jude Home Care, located at 445 Reservoir Avenue, Cranston. In addition, Orfa Lemaire (age 37), of East Greenwich, the director of clinical services, was charged with five counts of conspiracy to commit Medicaid fraud.
Pascale was arraigned today in Providence County Superior Court. She was released on $10,000 personal recognizance. A pre trial conference is scheduled for June 29, 2015. Orfa is scheduled to be arraigned in Providence County Superior Court on April 28, 2015.
It is alleged that between 2010 and 2013, St. Jude placed unlicensed certified nursing assistants (CNAs) in patients' homes and fraudulently billed Medicaid for CNA services in the amount of approximately $785,000.
The investigation was referred to the Office of Attorney General by the Rhode Island Executive Office of Health and Human Services (EOHHS) Program Integrity Unit after it was discovered through a routine audit that St. Jude was submitting billing forms with what is alleged to be altered dates that fraudulently reported in-home nursing surveys had been conducted on high-acuity patients. While checking further into that aspect of the case, the Program Integrity Unit discovered what is alleged to be time sheets for billing that had been submitted by persons who were not licensed CNAs.
Once referred to the Medicaid Fraud Control Unit at the Office of Attorney General, a formal investigation was initiated.
Through a separate action by the United States Health and Human Services Centers for Medicare and Medicaid Services (CMS) St. Jude's certification was revoked on July 15, 2014 as a result of a deficient compliance inspection, thereby terminating the company's ability to receive payments from Medicare. On July 20, 2014, EOHHS also suspended St. Jude from participation in the RI Medical Assistance Program.