East Windsor Agency Owner Arrested In Medicaid Fraud Scheme

EAST WINDSOR, CT — The owner of the Elegant Clinical Corporation in East Windsor has been charged in connection with a scheme in which she billed Medicaid for services that were never provided to the purported recipients.

Karen Gaston, 39, of East Granby, was charged Tuesday with first-degree larceny by defrauding a public community, health insurance fraud and criminal attempt to commit first-degree larceny by defrauding a public community. She was released on a $75,000 non-surety bond, and is scheduled to appear Sept. 30 in Hartford Superior Court.

Elegant Clinical Corporation is a non-profit agency serving people with disabilities, according to a listing on the East Windsor Chamber of Commerce website.

According to an arrest warrant, a 2018 audit of Elegant Clinical Corporation Medicaid billings by the Connecticut Department of Social Services, which administers the state’s Medicaid program, revealed a 57 percent error rate in which Medicaid was billed for services not provided, according to a statement from the State of Connecticut Division of Criminal Justice (DCJ).

Subsequent investigation disclosed numerous conflicting claims, where the client was actually being treated elsewhere on dates billed by Elegant Clinical. Additionally, most of the visits billed by Elegant Clinical were supported by false or blank documentation in the clients’ files. In all, Medicaid was falsely billed $52,648.97 for 10 clients that never received the billed-for services, according to the DCJ.

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