N.J. Woman Pleads Guilty to Fraud

September 18, 2003

Attorney General Peter C. Harvey announced that the administrator of a Camden County outpatient mental health clinic has pleaded guilty to Medicaid Fraud for inflating more than $13,000 worth of patient billings submitted to the state Medicaid Program. The Medicaid Program, funded by the state and federal governments, 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, Maria Carmen Cruz, 39, Red Lion Rd., Phila., pleaded guilty before Camden County Superior Court Judge Irvin J. Snyder to a charge of Medicaid Fraud. Cruz is scheduled to be sentenced by Judge Snyder on Dec. 5, 2003.

Gooden Brown noted that Cruz was charged by the Division of Criminal Justice – Office of Insurance Fraud Prosecutor via a State Grand Jury indictment returned on March 13. At the guilty plea hearing, Cruz admitted that from May – October, 1999, she submitted more than $13,000 in fraudulent invoices to the Medicaid Program for payment for mental health counseling and psychological services which were never provided. Specifically, Cruz falsely billed Medicaid by submitting bills for mental health counseling services purportedly provided to family members during group sessions; in fact, no such sessions were provided as family members were treated in single sessions. Medicaid regulations prohibit billing for multiple family members. Cruz also billed for mental health counseling sessions rendered to children when no such services were provided.

The investigation was coordinated by the Division of Criminal Justice – Office of Insurance Fraud Prosecutor, Medicaid Fraud Section. State Investigator Joseph Jaruszewski and Deputy Attorneys General Joie Piderit and William Hoyman conducted the investigation. DAG Hoyman represented the Division of Criminal Justice – Office of the Insurance Fraud Prosecutor at the guilty plea hearing.

“The Medicaid Program is funded through tax dollars and is in place to provide health care and related services to persons who may not otherwise have access to such services,” Insurance Fraud Prosecutor Gooden Brown said. “When service providers steal from the Medicaid Program, they are stealing from each and every New Jersey taxpayer and denying badly needed health care services to those who are least able to afford them. The Office of Insurance Fraud Prosecutor will continue to investigate and prosecute these cases.”

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