TRENTON
- Division of Criminal Justice Director
Vaughn L. McKoy announced that a Bergen
County pharmacist has been suspended from
dispensing controlled medications and
barred from participating in the federal-state
Medicaid Program as part of a court-ordered
sentence after seeking more than $35,000
in Medicaid payments for prescription
drugs that were never prescribed or distributed
to patients. 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 Insurance Fraud Prosecutor
Greta Gooden-Brown, Jennifer Kim, 38,
Inwood Terrace, Fort Lee, Bergen County,
was ordered to surrender her professional
license for one year, barred from participating
in the Medicaid Program for five years,
ordered to serve one year probation, and
fined $1,000 by Bergen County Superior
Court Judge Donald R. Venezia. The sentence
was imposed on Dec. 5.
.
Insurance Fraud Prosecutor Gooden Brown
noted that Kim, the owner/pharmacist of
the now defunct Medicine Shoppe pharmacy
located in Arlington, Hudson County, pleaded
guilty to a charge of Medicaid Fraud contained
in a criminal Accusation. At the guilty
plea hearing on Oct. 23, before Judge
Venezia, Kim admitted that from March
through August, 2001, she submitted dozens
of fraudulent bills to the Medicaid Program
for prescription medicines that were never
prescribed or provided to Medicaid patients.
The prescriptions were not prescribed
by any physician.
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 insurance fraud and
Medicaid fraud cases. State Investigator
Danielle Han and Deputy Attorney General
Mark J. Ondris were assigned to the investigation.
DAG Ondris 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 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."
Insurance Fraud Prosecutor Gooden Brown
noted that the Office of Insurance Fraud
Prosecutor realized a 143 percent increase
in indictments; a 91 percent increase
in defendants charged; a 79 percent increase
in convictions (trial convictions and
guilty pleas); and a 80 percent increase
in civil sanctions in 2002. The Office
of Insurance Fraud Prosecutor charged
225 defendants in 2002, versus 118 defendants
in 2001. Additionally, the Office of Insurance
Fraud Prosecutor imposed sanctions in
3,723 civil fraud cases in 2002, compared
to 2,063 civil sanctions obtained in 2001.
The Office of Insurance Fraud Prosecutor
collected $20.6 million in penalties in
2002, up from $15.8 million in 2001.
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
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