Nine Suspects Plot In $1 M Home Health Fraud

Pennsylvania Attorney-General (AG) filed the criminal charges based on evidence provided to a grand jury.

Nine suspects have been charged in Monroe County, Pennsylvania with what was deemed as “complex disability fraud scheme,” announced the Pennsylvania Attorney General’s office on March 29.

Attorney General Tom Corbett said the suspects conned four insurance companies by billing for home health care services that never took place. The bill amounted to around $1 million.

“Insurance fraud isn’t a victimless crime. When people deceive the system, it leads to increased insurance premiums for everyone,” said Corbett. “Almost every Pennsylvanian is feeling the burden of rising insurance costs. We take these allegations seriously.”

Investigators focused on two suspects, Judi Grate and Bianca Bucano, who are accused of being the brains behind the “Operation Forgery Factory” in which they submitted – over the past 10 years – forged documents to insurance companies that claimed they provided home health care. However these services were never carried out.

Corbett named Grate and Bucano’s accomplices as Melissa Bucano (Bucano’s daughter), Christopher Bucano (her son), Grate’s niece, Pecilla Grate Flowers of Georgetown, SC. Grace John of Blakeslee, Monroe County; Uhura “Nicole” Byrd of Newark, NJ; Barbara Rollins of Raeford, NC; and Patricia Lesane of Georgetown, SC are also charged.

Grate’s scheme

According to the grand jury, Grate claimed she was suffering from fibromyalgia and rheumatoid arthritis and required home care services. From June 20, 2000 to January 20, 2010, she submitted invoices and receipts to either the Philadelphia American Life Insurance Company (PALIC) or the Genworth Life Insurance Company. Genworth reimbursed her $361,289, while PALIC gave her $368,000.

All the other suspects took part by fraudulent means completing and signing caregiver invoices and receipts, the grand jury said.

Investigators found out that despite Grate being unemployed, she bought a time-share and three Cadillacs.

Mother-daughter plot

Bianca Bucano and her daughter Melissa stole more than $371,000 from AIG Centennial Insurance Company, Metropolitan Life Insurance Company and the Pennsylvania Commission on Crime and Delinquency Victim’s Compensation Program (PCCD), with Grate helping them.

In June 2004, Bianca Bucano submitted a fraudulent claim with MetLife, which stated that she was recently diagnosed with fibromyalgia and was getting home care services from J Grate Home Health Services. With fake invoices, she even claimed that her son, Christopher Bucano, provided her with 10 hours of home care services a day effective from January 13, last year through September 30, 2009.

Bucano bilked MetLife more than $321,000.

More fraud

Bucano filed a fraudulent claim with AIG for a hit-and-run accident that took place in November 2000. Later, investigators found out that the accident just involved two drivers’ side mirrors colliding and no injuries were reported. Bucano got about $150,000 from AIG as reimbursements for the fake invoices that she submitted to the insurance company.

She said that she received home care services on a daily basis from J Grate Home Health Services between July 30, 2001 and January 4, 2004 for injuries that she allegedly suffered in the accident, said the grand jury. But, AIG settled the case for $15,000.

In the mean time, Bucano received $35,000 from Pennsylvania Commission on Crime and Delinquency (PCCD), Victim’s Compensation Program for the same fraudulent car-accident claim.

The Attorney-General’s office said, each suspect is charged with 16 counts of forgery, 13 counts of insurance fraud, four counts of theft by deception, three counts of criminal attempts – theft by deception, two counts of corrupt organizations and one count each of theft by failure to make the required disposition of funds, dealing in proceeds of unlawful activity and criminal conspiracy.