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The Perfect Pair

Healthcare-Medicare-6
Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

A Calvert City, Ky., couple has been convicted of defrauding the Kentucky Medical Assistance Program, also known as Medicaid, out of nearly $8,000. Melissa Dufay, 51, and her husband Ray Dufay, 54, defrauded the government healthcare program for more than a year. (I guess you could say that the couple that commits fraud together, stays together.)

Melissa Dufay was a Medicaid recipient enrolled in the Home and Community Based (HCB) Waiver Program. This program provides assistance to the elderly and adults with disabilities, so they can live independently for as long as possible. (The only thing Melissa Dufay needed assistance with was furthering her scheme. That’s where her husband came in.)

Together the Dufays came up with a scheme to defraud Medicaid by listing Ray Dufay as his wife’s caretaker through the HCB waiver program. The couple prepared and submitted fraudulent timesheets to Medicaid for Ray Dufay for over a year. (If everyone could get a government paycheck for taking care of their spouse, perhaps the divorce rate would be lower.)

The timesheets that Ray Dufay submitted claimed that he provided health, safety, and welfare services to his wife. These services were never rendered. (So much for being a good husband and caretaker.) Dufay also received more than $500 from the Kentucky Medicaid program that he was not entitled to. (The couple took funds away from struggling individuals so that they could increase the balance in their joint bank account.)

Both Melissa and Ray Dufay pleaded guilty to one count of devising or engaging in a scheme to defraud Medicaid of $300 or more in November 2020. Ray Dufay also pleaded guilty to one count of theft by deception over $500 but less than $1,000. These are both Class D felonies.

The Dufays were sentenced to five years on each count, probated five years, and ordered to pay $7,705 in restitution to the Kentucky Medical Assistance Program. (They’ll have to pay back every last penny they took.) Ray Dufay was also sentenced to six months of home incarceration. (Congratulations to the State of Kentucky for making sure these two fraudsters were identified and prosecuted.)

Today’s Fraud of the Day comes from an article, “Calvert City couple convicted for nearly $8,000 in Medicaid fraud,” published by WPSD on February 3, 2021.

MARSHALL COUNTY, KY — A Calvert City couple has been convicted for defrauding the Kentucky Medical Assistance Program (Medicaid) of nearly $8,000, according to Kentucky Attorney General Daniel Cameron.

Cameron says an investigation found Melissa Dufay, who was a Medicaid recipient enrolled in the Home and Community Based Waiver Program, employed her husband Ray Dufay. Together, Cameron says, the couple prepared and submitted fraudulent timesheets for Ray Dufay for over a year.

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