( CNN ) -- Agents arrested 20 out of 42 people accused in a California Medicaid fraud ring that allegedly bilked the state out of nearly $ 4.6 million and put the lives of disabled children at risk , a prosecutor said . The defendants are accused of either posing as licensed nurses or organizing a scheme to send unlicensed nurses to provide home- or school-based care to disabled patients , many of them children with cerebral palsy or other developmental disabilities , the office of the U.S. attorney for central California said in a written statement . The long defendant 's list makes the case the largest of Medicaid fraud in California , U.S. Attorney Thomas O'Brien said in the statement . Each defendant has been charged with conspiracy to commit health care fraud and at least one count of health care fraud , according to the statement . Some parents and patients became suspicious of the nurses when they noticed their lack of skills . `` In one case , a 'nurse ' was unable to replace a tracheotomy tube that had fallen out of a young patient 's neck . In another case , an impostor nurse simply fled a medical situation when she apparently was unable to provide assistance , '' according to the statement . Some of the unlicensed nurses had foreign training , but never passed a U.S. qualifying nursing exam , the attorney 's office said , while others had no medical training at all . Two defendants -- Susan Bendigo and Priscilla Villabroza , the accused ringleaders -- were charged separately . Bendigo and Villabroza instructed the workers to lie about their status and used the names of licensed nurses on documents , the indictment says . Villabroza operated a home health agency -- the Santa Fe Springs company Medicare Plus Home Health Providers -- the indictment said . Villabroza , a registered nurse , knowingly hired unlicensed nurses and billed Medi-Cal , California 's Medicaid program , for the work of licensed vocational nurses from August 2004 through 2007 , the indictment alleges . Villabroza pleaded guilty last year to five federal counts of health care fraud , the attorney 's office said . Bendigo , a registered nurse , was also director of Santa Fe Springs ' Excel Plus Home Health Services , which provided nurses to home health agencies , according to the indictment . Bendigo also was charged last year but fled the country , the statement said . Officials think she is hiding in the Philippines , said U.S. attorney 's spokesman Thom Mrozek . Villabroza is awaiting sentencing , and could be sent to prison for up to 50 years , Mrozek said . Each of the 42 new defendants faces a statutory maximum penalty of 10 years in federal prison for each charge if convicted , according to the statement .
Prosecutor : The prosecutor is the person who decides whether or not to charge a suspect with a crime. `` Nurses '' cared for disabled patients , many of them children , in homes , schools . Patients became suspicious of nurses when they noticed their lack of skills . Ringleaders accused of telling workers to lie about status , using real nurses ' names .