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 Ocean
County pharmacist with submitting more
than 235 claims to the Medicaid Program
for prescription drugs that he did not
dispense.
According to Insurance Fraud Prosecutor
Greta Gooden Brown, William J. Adamshick,
44, Hemlock Drive, Lanoka Harbor, Ocean
County, was charged with Health Care Claims
Fraud (2nd degree), Medicaid Fraud (3rd
degree). If convicted of both counts,
Adamshick faces up to 13 years in state
prison and a fine of up to $160,000. The
case will also be referred to the Board
of Pharmacy for action it may deem appropriate
with regard to Adamshick’s pharmacist’s
license. Adamshick will be ordered to
appear in Ocean County Superior Court
for an arraignment and bail hearing on
a date yet to be determined.
The indictment alleges that between May
2000 and January 2002, Adamshick, a licensed
pharmacist in the State of New Jersey,
allegedly submitted more than 235 claims
to the Medicaid Program for a prescription
pain-reliever drug known as Stadol. An
investigation by the Division of Criminal
Justice - Office of Insurance Fraud Prosecutor
determined that Adamshick fraudulently
billed the Medicaid Program more than
$25,000 for Stadol prescriptions that
were billed for a single Medicaid beneficiary
but never dispensed to her.
State Investigator Anthony Iannice and
Deputy Attorney General Erik Daab were
assigned to the investigation. DAG Daab
represented the Division of Criminal Justice
- Office of Insurance Fraud Prosecutor
before the State Grand Jury.
“Abuse
of the Medicaid Program and insurance
fraud by persons who hold professional
licenses are particularly disturbing crimes,”
Insurance Fraud Prosecutor Greta Gooden-Brown
said. “Not only do such Medicaid
fraud 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 Insurance Fraud Prosecutor.”
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 the Insurance
Fraud Prosecutor’s Medicaid Fraud
Section, which investigates both criminal
and civil Medicaid fraud and abuse in
that program.
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
.”
The indictment, which was handed up to
Mercer County Superior Court Judge Charles
A. Delehey on April 29, is merely an accusation.
The defendant is presumed innocent unless
and until proven guilty beyond a reasonable
doubt.