Former Groton Nurse Charged with Health Insurance Fraud, Prescription Violations

GROTON, CT - State police said a former advanced practice registered nurse (APRN) with an office in Groton was arrested Wednesday. She is charged with billing Medicaid for prescriptions that were never provided to the purported recipients, according to a release.

Arlene Dumais, 77, of Preston was arrested by inspectors from the Medicaid Fraud Control Unit (MCFU) and charged with health insurance fraud and making a false prescription. (To sign up for Groton breaking news alerts and more, click here.)

According to an arrest warrant, Dumais wrote more prescriptions than any other health care provider in Connecticut for Vivitrol over a four-year period beginning in 2010. The state paid $1,100 or more for each prescription, police said.

Vivitrol is an injectable medication used to treat opiate and alcohol addiction.

An investigation by the Drug Control Division in the Department of Consumer Protection found that she wrote nearly 10 times the number of prescriptions as the next highest provider, which was a three-person combined practice. Dumais prescribed Vivitrol on a monthly basis to Medicaid recipients who were either no longer her patients or whom she had never treated, the affidavit states.

Over the four-year period under review the state Department of Social Services, which administers the Medicaid program, paid nearly $2.3 million for the prescriptions. A random review of three patients revealed at least 21 instances where Medicaid paid for Vivitrol that was not dispensed to the recipient for whom it had been prescribed, police said.

Dumais was released on a $25,000 non-surety bond and is scheduled to appear in court May 18. Both charges are punishable by up to five years in prison, police said.

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