Bryan Harr, left, and Melissa Harr of Bristol, Va., who pleaded guilty this month to Medicaid fraud charges. (Bristol Police Department)

Medicaid fraud is nothing new, but sometimes it’s particularly disgusting.

This is an appalling story about a Medicaid-supported caretaker and two parents who made their three children, including a severely disabled teen, live in filth in their Bristol, Va. home.

The conditions were so bad that a putty knife was needed to remove the children’s feces from their bedroom, where they were locked in at night.

If there’s any good news in this story, it is that the parents, Bryan and Melissa Harr, ages 41 and 49, and the caretaker, Deborah Branch, 65, were sentenced to prison earlier this month on federal health-care conspiracy charges. The Harrs were already in state prison for child abuse and had lost custody of their children.

But not before they schemed with Branch to steal government money meant to provide care for their teenage son, identified as E.H., who has intellectual disabilities and cerebral palsy. From January 2010, when the children were 4, 5 and 12, until September 2015, Branch kicked back money to the parents paid to her for taking care of E.H. Families can select caretakers who are paid through Medicaid for services to eligible recipients.

Branch, however, didn’t work for her pay. In fact, investigators have evidence she was vacationing in Myrtle Beach, S.C., during a period her time sheets indicated she was with E.H. The Harrs knew she submitted bogus time sheets that led to Branch getting almost $208,000 over the five-year period. Out of that, she slipped the parents $200 every two weeks while E.H. was neglected.

“It is shocking to imagine parents who would for many years neglect their disabled child and allow him to suffer horribly while they worked to steal taxpayer money meant to pay for the child’s much-needed care,” said Nick DiGiulio, a special agent with the Department of Health and Human Services, Office of Inspector General.

When Bristol Police Department Detective Robin McCoy was called to investigate conditions at the house, following complaints by the Virginia Department of Social Services, her nose immediately told her something was wrong.

“It was really unbelievable,” she said. “The smell was enough to alert anyone.”

Excrement stains were everywhere — on the floor, the walls and two twin-size mattresses on the floor.

“There was just so much of it,” McCoy said. “It was just horrible.”

There were no lights in the room. There was no furniture, save the fouled mattresses. The windows had been screwed shut and there was a lock on the outside of the bedroom door. E.H. and his two younger brothers went to school, but were locked up overnight.

“The boys spent long hours locked in the bedroom without toys, lights, electricity or bathroom privileges,” said Jeff Overbeck, a special agent in the inspector general’s office. “The children had crafted [a] toy soldier out of mattress stuffing in order to have something to play with.”

E.H. is now in an assisted-living group home, and the younger boys are in foster care.

While there are numerous personal care services fraud cases throughout the country, Overbeck described this as “one of the most egregious.” Personal care programs “need a lot more oversight,” he said. The inspector general recommended additional safeguards to protect clients. From 2010 to 2016, the inspector general’s office opened more than 200 investigations into Medicaid personal care services fraud.

A sentencing memo from attorney Dan Bieger, on behalf of Melissa Harr, essentially blamed her husband for the crimes. It outlines her multiple battles with cancer, starting at age 4, her use of powerful opioid painkillers and how she worked two jobs, as a cook and nursing assistant.

While “she was in bed constantly” downstairs, “her children were being neglected upstairs,” Bieger’s memo says. “She was running out of money and asked her husband to pawn the television.”

Bryan Harr, 41, told her “to hold off because we have Deborah Branch’s money coming in,” according to the memo. “She learned from Bryan that he made a deal with Deborah Branch … to sign off on her fraudulent time sheets in exchange for the payment of $200 every two weeks. Melissa was too weak physically and economically to resist. Although she was initially against the deal, she did not oppose it and facilitated it.”

The judge didn’t buy this sob story and gave both parents the same sentence.

The Harrs each got four years. Branch was sentenced to six years in prison. All pleaded guilty. Branch was also convicted of wire fraud. The Harrs’ federal sentences will be served after their state prison terms, which were four years six months for Bryan and three years for Melissa. Branch did not face state charges.

Lawyers for Branch and Bryan Harr provided no information regarding their clients.

The federal punishment exceeded sentencing guidelines. When the prison terms were announced, Overbeck said that U.S. District Judge James P. Jones condemned Branch and the Harrs for their “‘brazen greed that was beyond understanding.’ ”

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