Massachusetts Inmate Rips Off State Health Program for $157K While Behind Bars

It sounds like the plot of a bad crime drama: a convicted felon serving time for armed robbery and rape somehow manages to rip off the state of Massachusetts for nearly a quarter of a million dollars — all while locked up. But that’s exactly what happened in the case of Victor Simard, and it’s a troubling reminder of just how vulnerable state-run programs are to fraud, even from behind prison walls.

According to the Massachusetts Attorney General’s Office, Simard pleaded guilty this week to defrauding the state’s MassHealth Personal Care Attendant (PCA) program. While incarcerated since 2019, Simard conspired with a woman named Jasmin Bryan to submit fraudulent timesheets claiming he was providing in-home personal care services — an impossible feat, considering he was physically in prison during the entire timeframe in question. Despite the blatant impossibility of the claims, MassHealth paid out over $157,000 for these phantom services.

This wasn’t a simple clerical error or a loophole someone stumbled into. It was an intentional, coordinated fraud. Jail phone recordings reveal that Simard and Bryan were fully aware of what they were doing and split the money accordingly. Simard has now been sentenced to another year in state prison, with three years of probation to follow. He’s also been banned from participating in any kind of elder care or PCA work in the future — a move that, frankly, should have been unnecessary had proper oversight been in place.

So how does something like this even happen? How does a man who’s been behind bars since 2019 still manage to “work” as a PCA on paper — and get paid for it? The answer lies in the systemic vulnerabilities baked into programs like MassHealth’s PCA initiative.

The PCA program is designed to help people with chronic or long-term disabilities live independently by paying for essential personal care services. These services are supposed to be performed by trained individuals — often family members — who assist with tasks like bathing, dressing, and mobility. It’s an important safety net for many vulnerable residents of Massachusetts. But as this case and others reveal, the program is alarmingly easy to exploit.

And it’s not just this one instance. Simard’s case is just the latest in a string of frauds targeting the PCA program. Earlier this year, the AGO indicted four individuals for submitting over $500,000 in false claims. Another individual recently pleaded guilty and received a suspended sentence for similar fraud. These are not isolated events — they’re part of a pattern that exposes massive lapses in accountability.

The MassHealth PCA program, like many government-run initiatives, relies heavily on trust — trust that services are being provided, that timesheets are honest, and that no one is gaming the system. But when verification is little more than a rubber stamp and oversight is spotty at best, the door is wide open for exploitation.

And the funding? It’s no small sum. The Medicaid Fraud Division of the AGO operates on a federal grant totaling nearly $6 million, with additional millions from the state itself. With that kind of money flowing through the system, the idea that a man could orchestrate a complex fraud operation from his prison cell is more than just embarrassing — it’s infuriating.

The real issue here isn’t just one fraudster, or even a handful of them. It’s that the safeguards in place to prevent this sort of thing clearly aren’t working. The PCA program is crucial, but it’s also being undermined from within, and that puts the people it’s meant to help at real risk.

We should be asking tougher questions: How many other fake claims have slipped through? How rigorous is the verification process? Who’s responsible for auditing these payouts — and how did they miss a guy serving time?

Fraud in government programs isn’t just a fiscal issue; it’s a trust issue. When people see headlines like this, they lose faith not just in the programs themselves, but in the institutions running them. And that erosion of trust can be far more damaging than the financial losses.

Let Simard’s case be a wake-up call. If a man can steal from a public healthcare program while behind bars, it’s not just a loophole. It’s a failure of oversight. And it needs to be fixed.

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