TRENTON
- Attorney General Peter C. Harvey announced
that an Essex County man has pleaded guilty
to Medicaid Fraud and receiving stolen
property in connection with using stolen
Medicaid cards to obtain narcotic drugs
at the expense of the Medicaid Program.
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, Douglas
Tyer, 47, of 1st Street, Newark, Essex
County, pleaded guilty before Union County
Superior Court Judge James C. Heimlich
to charges contained in two separate criminal
Accusations filed by the Division of Criminal
Justice - Office of Insurance Fraud Prosecutor.
One Accusation charged Tyer with Medicaid
Fraud and the other charged receiving
stolen property -- both third degree offenses.
When sentenced on Jan. 30, 2004, Tyer
faces up to six years in state prison
and a fine of up to $20,000.
At the Dec. 10 guilty plea hearing, Tyer
admitted that he obtained stolen Medicaid
recipient cards which entitle the bearer
to medical benefits, including prescription
drugs, paid for by the Medicaid Program.
Tyler also admitted that he obtained stolen
written prescriptions, purportedly issued
by doctors for various narcotic medicines,
in order to obtain narcotic drugs for
personal use.
The investigation was conducted by the
Division of Criminal Justice - Office
of Insurance Fraud Prosecutor. 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 guilty plea hearing.
"The
Medicaid Program was designed to provide
medical benefits to persons not otherwise
able to afford medical care," Insurance
Fraud Prosecutor Gooden Brown said. "Because
the Medicaid Program is funded by tax
dollars, the defendant not only abused
the health coverage aspects of the Program,
but also stole tax dollars."
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
licenses.
An indictment is merely an accusation.
The defendant is presumed to be innocent
of the charges unless and until proven
guilty beyond a reasonable doubt.
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