Owner of Hudson County Medical Equipment Supply Store Pleads Guilty To $100,000 from Medicaid Fraud Scam
released on August 21, 2017
found in newsletter: August 2017
TRENTON –Attorney General Christopher S. Porrino and the Office of the Insurance Fraud Prosecutor (OIFP) announced today that the owner of a Hudson County medical equipment supply store has pleaded guilty to fraudulently billing the Medicaid program more than $100,000 for medical supplies never provided to patients.
Alfredo Valdes, Jr., who owns T-N-T medical supplies in West New York, pleaded guilty to second-degree charges of health care claims fraud and theft by deception in a hearing before Superior Court Judge Mitzy Galis-Menendez in Hudson County. Under the terms of the plea agreement, the State will recommend that the 42-year-old Clifton resident be sentenced to four years in state prison. Valdes will also pay $101,000 in restitution to Horizon New Jersey Health, and sign a consent order agreeing to lifetime disbarment from participation as a provider in the New Jersey Medicaid program.
“Stealing from a program that provides financial assistance to those who cannot afford health insurance or health care services is not only a crime, it’s a disgrace,” said Attorney General Porrino. “This guilty plea ensures that the defendant will be held accountable for his actions and will never again be in a position to divert resources from those who truly need it.”
“Every dollar lost to Medicaid fraud is one less dollar available to help some of the most vulnerable citizens of our state,” said Acting Insurance Fraud Prosecutor Christopher Iu. “Our Medicaid Fraud Control Unit will continue to aggressively investigate and punish those exploit the Medicaid system for their personal enrichment.”
In pleading guilty, Valdes admitted that between January 2008 and March 2016 he fraudulently submitted claims totaling more than $100,000 to Horizon NJ Health, a provider of Medicaid services in the state. The claims falsely stated that Valdes had distributed durable medical equipment – including compression stockings, diapers and other items – to patients who, in fact, had died prior to the dates of the purported distributions.
Valdes is scheduled to be sentenced on January 5, 2018.
Deputy Attorney General Melissa Simsen represented the State in the plea hearing. Detectives Anthony Iannice and Kylie Mattis coordinated the investigation with assistance from Det. Megan Brennan of the Special Investigation Unit at Horizon New Jersey Health, and Analysts Keira McRae-Wiggins and Kelly Celenza. Acting Insurance Fraud Prosecutor Iu thanked the SIU Unit at Horizon for referring the matter to the Office of the Insurance Fraud Prosecutor.
John Lynch, Esq. represented Valdes at the plea hearing.
Acting Insurance Fraud Prosecutor Iu noted that some important cases have started with anonymous tips. People who are concerned about insurance cheating and have information about a fraud can report it anonymously by calling the toll-free hotline at 1-877-55-FRAUD, or visiting the Web site at www.NJInsurancefraud.org. State regulations permit a reward to be paid to an eligible person who provides information that leads to an arrest, prosecution and conviction for insurance fraud.
Original Press Release