TRENTON - Division of Criminal Justice Director Vaughn L. McKoy announced that the Division of Criminal Justice - Office of Insurance Fraud Prosecutor has obtained a State Grand Jury indictment charging an Essex County woman with Health Care Claims Fraud and Medicaid Fraud for submitting more than $54,480 in fraudulent bills to the Medicaid Program as part of a patient transportation scam.

According to Insurance Fraud Prosecutor Greta Gooden-Brown, Mary Villone, 47, Center Street, Nutley, Essex County, was charged in a State Grand Jury indictment with Health Care Claims Fraud (2nd degree) and Medicaid Fraud (3rd degree). If convicted, Villone faces up to 13 years in state prison and a fine of up to $160,000.

The indictment alleges that between January, 2002 and February 2004, Villone, who was employed as the administrator of PE Medical Transport, Inc., Halstead Street, East Orange, Essex County, submitted more than 2,450 claims totaling more than $54,480 to the Medicaid Program for transportation services which were not provided. The investigation by the Division of Criminal Justice - Office of Insurance Fraud Prosecutor determined that PE Medical Transport provided mobility assistance vehicles and transportation assistance to Medicaid patients, including disabled children, and that Villone allegedly falsified bills sent to Medicaid by including the names of beneficiaries who did not receive the services. As part of the investigation, the Division of Criminal Justice - Office of Insurance Fraud Prosecutor “froze” PE Transportation Inc.’s bank accounts to begin the process of recovering the money stolen from the Medicaid Program. PE Transportation, Inc. has since paid $204,00 restitution and $204,000 in civil false claims penalties. The indictment was handed up to Mercer County Superior Court Judge Linda R. Feinberg, the Assignment Judge in charge of the State Grand Jury, on Dec. 7. Villone will be ordered to appear in Essex County Superior Court for arraignment and bail on a date to be determined.

State Investigators Anthony Iannice and Robert McGrath, and Deputy Attorney General Erik W. Daab and DAG Marquis Jones were assigned to the investigation. DAG’s Daab and Jones represented the Division of Criminal Justice - Office of Insurance Fraud Prosecutor before the State Grand Jury.

The Medicaid Program, which is 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. The State of New Jersey administers the Medicaid Program through the Division of Medical Assistance and Health Services and through the Office of Insurance Fraud Prosecutor’s Medicaid Fraud Section.

“Abuse of the Medicaid Program is particularly disturbing,” said Insurance Fraud Prosecutor Gooden-Brown. “Not only do Medicaid fraud schemes involve theft of tax dollars, such schemes 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 Insurance Fraud Prosecutor.”

Noting that some important cases have begun with anonymous tips from the public, Prosecutor Brown emphasized that individuals can make a difference. “We need people’s information, not their identities. People who are concerned about insurance cheating and have any information about a fraud can call our toll-free hotline at 1-877-55-FRAUD, or visit our Web site at www.NJInsurancefraud.org.”

An indictment is merely an accusation. The defendant is presumed innocent unless and until proven guilty beyond a reasonable doubt.

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