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Health fraud

HARRISBURG Attorney general agents Monday arrested nine suspects for allegedly devising a complex disability fraud scheme in Monroe County. The suspects allegedly bilked four insurance companies out of more than $1 million by billing for home health care services that were not provided.

Attorney General Tom Corbett said that the investigation centered on Judi Grate and Bianca Bucano, both of Effort.Grate and Bucano are charged with being the architects of a criminal plan that attorney general agents have termed, "Operation Forgery Factory." For the past decade they submitted forged documents to insurance companies that claimed they provided home health care, when in fact, little or none was provided.To help carry out the fraud, Grate and Bucano enlisted the help of seven other suspects. Bucano recruited her daughter, Melissa Bucano, and her son, Christopher Bucano. Grate's niece, Pecilla Grate Flowers, of Georgetown, S.C., also participated in the scheme.Also charged are Grace John of Blakeslee, Monroe County; Uhura "Nicole" Byrd of Newark, N.J.; Barbara Rollins of Raeford, N.C.; and Patricia Lesane of Georgetown, S.C.Evidence and testimony regarding the alleged criminal activity was presented to a statewide investigating grand jury, which recommended the criminal charges being filed Monday."Insurance fraud is not a victimless crime. When people cheat the system, it leads to increased insurance premiums for everyone," Corbett said. "Almost every Pennsylvanian is feeling the burden of rising insurance costs. We take these allegations very seriously."Judi GrateThe grand jury found that Grate claimed that she was suffering from fibromyalgia and rheumatoid arthritis and needed home care services. Each day from June 20, 2000, to Jan. 20, 2010, Grate submitted invoices and receipts to either the Philadelphia American Life Insurance Company (PALIC), or the Genworth Life Insurance Company. Grate received $361,289 from Genworth and $368,000 from PALIC.According to the grand jury, all of the other co-defendants, except for Christopher Bucano, assisted Grate by fraudulently completing and signing caregiver invoices and receipts.Other than allegedly stealing money from insurance companies, Grate was not employed, yet she purchased a time-share and three Cadillacs.Bianca BucanoThe grand jury found that Grate assisted Bianca Bucano and Melissa Bucano in stealing 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).In June 2004, the grand jury found that Bianca Bucano filed a fraudulent claim with MetLife on a long-term care policy that she purchased in January 2004. Bianca Bucano stated in her claim that she was recently diagnosed with fibromyalgia and was receiving home care services from J. Grate Home Health Services.The grand jury also found Bianca Bucano submitted fraudulent invoices to MetLife stating that her son, Christopher Bucano, provided her with 10 hours of home care services a day from Jan. 13, 2009 through Sept. 30, 2009.The grand jury found that during many days from Jan. 13, 2009 through Sept. 30, 2009, Christopher Bucano was incarcerated, hospitalized or attending court hearings.Bianca Bucano fraudulently received more than $321,000 from MetLife.According to the grand jury, Bianca Bucano also filed a fraudulent claim with AIG following a hit-and-run accident that occurred in November 2000. The accident consisted of two driver's side mirrors colliding and no injuries were reported.Bianca Bucano, is charged with submitting $150,000 worth of fraudulent invoices to AIG stating 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.AIG settled the case for $15,000.According to the grand jury, Bianca Bucano also filed a fraudulent claim with the Pennsylvania Commission on Crime and Delinquency (PCCD), Victim's Compensation Program requesting compensation in connection with the November 2000 auto accident. PCCD reimburses crime victims for expenses they face as a result of a crime.Corbett said that Bianca Bucano submitted invoices to PCCD indicating that she received home care services on a daily basis from J. Grate Home Health Services between May 1, 2002 and April 18, 2005.The invoices totaled $165,970. PCCD paid $35,000 in connection with Bucano's claim, which was the maximum amount that the agency was permitted to pay.The defendants were preliminarily arraigned Monday before Monroe County Magisterial District Judge Debby A. York. They will be prosecuted in Monroe County by Deputy Attorney General Jennifer A. Peterson of the Attorney General's Insurance Fraud Section.Each of the defendants are charged with 16 counts of forgery, 13 counts of insurance fraud, four counts of theft by deception, three counts of criminal attempt theft by deception, two counts of corrupt organizations and one count each of theft by failure to make required disposition of funds, dealing in proceeds of unlawful activity and criminal conspiracy.Below is a list of the defendants' names and addresses:Judi Grate, 59, 216 Birch Hollow Drive, Effort, Monroe County.Bianca Bucano, 59, 2 Harvest Hill Drive, Effort, Monroe County.Melissa Bucano, 21, 2 Harvest Hill Drive, Effort, Monroe County.Christopher Bucano, 27, 2211 Arlene Drive, Effort, Monroe County.Barbara Rollins, 62, 702 Saunders Street, Raeford, N.C.Uhura "Nicole" Byrd, 37, 214 Avon Avenue, Apt. 2A, Newark, N.J.Grace John, 48, 2425 Yellowstone Drive, Blakeslee, Monroe County.Patricia Lesane, 51, 92 Maidenbush Road, Georgetown, S.C.Pecilla Grate Flowers, 55, 120 Lincolnshire Drive, Georgetown, S.C.