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Office
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April 8, 2004 TEXAS-BASED
SUBSTANCE ABUSE COUNSELOR TO SERVE 7 YEAR JAIL TERM |
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TRENTON - Attorney General Peter C. Harvey announced that a New Jersey-licensed drug and alcohol rehabilitation and substance abuse counselor who operated a Passaic County counseling center has been sentenced to seven years in state prison for bilking the Medicaid Program out of more than $900,000 in counseling services that never occurred. The Medicaid Program is funded by the state and federal governments and provides health care services and prescription drugs to persons who may not otherwise be able to afford such services and medicines. According to Vaughn L. McKoy, Director, Division of Criminal Justice and Insurance Fraud Prosecutor Greta Gooden-Brown, Bennie M. Martin, 39, Houston, TX, was sentenced by Passaic County Superior Court Judge Ernest M. Caposela to seven years in state prison and ordered to pay $587,290 in restitution to the state Medicaid Program and to Passaic County. "This is a significant sentence and sends a message that corrupt medical service providers will be targeted for investigation and prosecution by the Office of Insurance Fraud Prosecutor," Attorney General Harvey said. "The sentence serves the public good and provides for the repayment of more than one-half million dollars to the State Medicaid Program." Insurance Fraud Prosecutor Gooden Brown noted that a January, 2003, State Grand Jury indictment charged Martin, the former President of Recovery Services, Inc., a drug and alcohol counseling center located at 474-476 Clifton Ave., Clifton, Passaic County, with Health Care Claims Fraud, misconduct by a corporate official, and Medicaid Fraud. In pleading guilty on March 8 before Judge Caposela, Martin admitted that from February, 2001 through September, 2002, he fraudulently obtained the names and identification numbers of more than 100 Medicaid recipients who were not patients of nor counseled at Recovery Services. The indictment charged that Martin and Recovery Services, Inc. then fraudulently billed the Medicaid Program more than $504,000 for nonexistent counseling sessions. Following the indictment, additional investigations by the Division of Criminal Justice revealed that Martin stole an additional $333,000 in the scheme. Martin was arrested in Houston, TX on Sept. 23, 2002, on the New Jersey arrest warrant. Based on an extradition request filed by the Division of Criminal Justice - Office of the Insurance Fraud Prosecutor, Martin was returned to New Jersey by the U.S. Marshal’s Service on Oct. 1, 2003. Bail was set at $1,000,000 by Passaic County Superior Court Judge Marilyn C. Clark on Oct. 2, 2003. The investigation was conducted by the Division of Criminal Justice - Office of Insurance Fraud Prosecutor’s Medicaid Fraud Section which investigates and prosecutes civil and criminal Medicaid fraud cases. State Investigator Michael English and Deputy Attorney General Dolores Blackburn coordinated the investigation with the assistance of Auditor Cleair Budhu of the Medicaid Fraud Section. DAG Blackburn represented the Division of Criminal Justice - Office of Insurance Fraud Prosecutor at the sentencing. "Abuse of the Medicaid Program and insurance fraud by persons who hold professional licenses are particularly disturbing crimes," said Insurance Fraud Prosecutor Gooden Brown. "Not only do such Medicaid fraud schemes involve theft of tax dollars, they also represent a theft from a program designed to assist persons who can not afford health insurance or health care services. Such cases are a priority for the Office of the Insurance Fraud Prosecutor." Noting that some important cases have begun with anonymous tips from the public, Insurance Fraud Prosecutor Gooden Brown encouraged anyone with information about insurance fraud to contact the Division of Criminal Justice - Office of Insurance Fraud Prosecutor’s toll-free hotline at 1-877-55-FRAUD, or to visit the insurance fraud web site at www.NJInsurancefraud.org . Housed in the Department of Law and Public Safety’s Division of Criminal Justice and reporting to the Attorney General, the Office of the Insurance Fraud Prosecutor was established by the Automobile Insurance Cost Reduction Act of 1998 (AICRA). The Office is the centralized state agency that investigates and prosecutes civil and criminal insurance fraud, as well as Medicaid fraud. Criminal convictions for insurance fraud can result in fines and imprisonment. Civil penalties can include substantial fines and referral for revocation or suspension of professional licenses.
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