Jean Renee Sparks, 46, of the 500 block of Alcott Street in Philadelphia, faces multiple felony counts related to a fraud incident, according to the Pennsylvania Attorney General.
According to a special agent with the Pennsylvania Office of the Attorney General, he received information of a possible Medicaid fraud committed by a personal care attendant (PCA), later identified as Sparks.
According to court documents, Sparks was hired as a PCA to provide services to two Medical Assistant recipients under the Department of Human Services Community Health Choices (CHC) Waiver Program. The CHC Waiver Program is a Medicaid funded, home and community-based waiver that allows individuals to live in the community and become as independent as possible. One of the services available under the waiver is PCA assistance with activities of daily living. The CHC waiver requires requires medical assistance patients to select a Managed Care Organization (MCO) to administer their PCAs. PCA agencies submit claims to these MCOs based on timekeeping entries submitted by the PCAs. The MCOs then issue payments to the agencies using medical assistance funds. The two victims used UPMC Health Plan and AmeriHealth Caritas as their MCOs.
Sparks was employed to provide services to one of the victims through Philadelphia Home Health Services dba Angels on Call, 261 Old York Road, Jenkintown. Sparks was employed to provide services to the second victim through Pristine Home Care, 5924 N. Broad Street, Philadelphia.
Police analyzed documents received from AmeriHealth, UPMC, Angels on Call, and Pristine Home Care, including timesheets, payroll records, and applications for employment that Sparks submitted. Police also analyzed timekeeping entries that Sparks submitted for care that she was allegedly providing to both victims from Oct. 4, 2022 to Nov. 5, 2023.
According to documents, Sparks was paid for at least 1,504.5 overlapping hours for services that could not have been rendered to more than one person at the same time, for which AmeriHealth and UPMC paid at least $32,376.84 in medical assistance funds.
After analyzing timekeeping entries that Sparks submitted to Angels on Call, police discovered that Sparks was paid for at least 1,037.75 hours while the victim was hospitalized, for which UPMC paid approximately $21,516.32 for services that were not rendered for the following time periods:
In total, Sparks submitted approximately 2,542.25 hours to Angels on Call and Pristine Home Care for services that could not have been rendered, causing UPMC and AmeriHealth to pay these agencies approximately $53,893.16 in excess medical assistance funds.
Sparks faces charges of
All suspects and defendants are innocent until proven guilty. This story was compiled using public court records.
