East Hartford Woman Charged in Alleged Medicaid Double-Payment Scheme
An East Hartford woman has been charged with allegedly collecting payments through two Connecticut Medicaid-funded programs for providing care to the same person during overlapping periods.
An East Hartford woman has been charged with allegedly collecting payments through two Connecticut Medicaid-funded programs for providing care to the same person during overlapping periods.
In an October 1 announcement, the Connecticut Division of Criminal Justice identified the defendant as Carmen Rivera-Rivera, 52. Inspectors from the Medicaid Fraud Control Unit arrested her on September 30 and charged her with health insurance fraud and first-degree larceny by defrauding a public community.
Prosecutors allege that she improperly obtained $18,202.98. The charges are accusations, and Rivera-Rivera is presumed innocent unless and until proven guilty in court.
Two programs, overlapping payments
According to prosecutors, Rivera-Rivera worked as a caregiver through the Adult Family Living Waiver program, which provides financial support to qualifying family members or friends who serve as primary caregivers in a home.
While working through that program, she also enrolled as a Personal Care Assistant for the same recipient. The PCA program helps people with severe, chronic disabilities obtain assistance with daily activities so they can remain in their homes and communities.
Investigators allege that, from June 25 through October 9, 2025, Rivera-Rivera submitted time sheets and received PCA payments while also being paid for Adult Family Living services during the same time.
The alleged misconduct concerns those overlapping payments — not the existence or legitimacy of either care program.
Protecting public healthcare funds
The case concerns money intended to support people who need care at home. It highlights the importance of accurate time sheets and oversight when services are funded through multiple programs.
The state announcement describes charges against one caregiver. It does not establish widespread wrongdoing within either program.
The Medicaid Fraud Control Unit investigated the case with assistance from the Connecticut Department of Social Services' Office of Quality Assurance and the Newington Police Department. The unit will also prosecute the case.
Rivera-Rivera was released on a $25,000 non-surety bond and is scheduled to appear in Manchester Superior Court on October 8, 2026.
Anyone with information about suspected fraud or abuse in the public healthcare system can contact Connecticut's Medicaid Fraud Control Unit at 860-258-5986.