East Hartford Woman Charged In Medicaid Fraud Case: State

EAST HARTFORD, CT — An East Hartford woman has been arrested on allegations that she improperly received more than $18,000 by billing a Medicaid-funded program while simultaneously being paid through another caregiver program for the same recipient, state officials said.

Carmen Rivera-Rivera, 52, of East Hartford, was charged Wednesday, Sept. 30, by inspectors with the Medicaid Fraud Control Unit in the Office of the Chief State's Attorney.

Subscribe

Investigators allege Rivera-Rivera was employed as a caregiver through the Adult Family Living Waiver program, or AFL, and later enrolled as a personal care assistant for the same recipient.

The AFL program provides financial assistance and support to family members or friends serving as primary in-home caregivers.

In contrast, the Medicaid-funded PCA program provides eligible recipients with funding to hire people to assist with daily self-care activities.

From June 25 through Oct. 9, 2025, Rivera-Rivera allegedly submitted timesheets and received payment for PCA services while simultaneously being paid to provide AFL services, according to the Medicaid Fraud Control Unit.

Authorities allege she improperly obtained $18,202.98.

The state provided the following arrest information.

She was charged with one count of health insurance fraud and one count of first-degree larceny by defrauding a public community.

She was released on a $25,000 non-surety bond and is scheduled to appear Oct. 8 in Manchester Superior Court.

Prosecutors allege the claims Rivera-Rivera submitted to the state Department of Social Services contained false, incomplete, deceptive, or misleading information.

Both charges are classified as Class B felonies and are each punishable by up to 20 years in prison, according to the Office of the Chief State's Attorney.

The Medicaid Fraud Control Unit investigated the case with assistance from the state Department of Social Services' Office of Quality Assurance and the Newington Police Department.

Anyone with information about suspected fraud or abuse involving the public health care system can contact the Medicaid Fraud Control Unit at 860-258-5986.

For information on the case, click on this link.