Rachel Sacharow 609-984-1936

TRENTON - Division of Criminal Justice Director Vaughn L. McKoy announced that an Essex County man has pleaded guilty to fraudulently misrepresenting that he and his family were qualified for Medicaid benefits.

According to Insurance Fraud Prosecutor Greta Gooden-Brown, Anthony Murphy, 49, of Kenz Terrace, West Orange, Essex County, pleaded guilty before Essex County Superior Court Judge Michael Ravin to a criminal Accusation filed by the Division of Criminal Justice. The Accusation charged Murphy with Medicaid Fraud, and failure to pay income taxes, (both 3rd degree). When sentenced on Sept. 9, Murphy faces up to eight years in state prison and a fine of up to $25,000.

At the June 29 guilty plea hearing, Murphy admitted that between May 30, 2001 and March 30, 2004, he wrongfully obtained health benefits from the Medicaid Program. Murphy admitted that he applied for FamilyCare for himself, his wife, and his three children by falsely advising the Division of Medicaid Assistance and Health Services that he did not have health insurance through his employment and could otherwise not afford health coverage. An investigation by the Division of Criminal Justice - Office of Insurance Fraud Prosecutor determined that Murphy falsely advised Medicaid that his income level qualified him to enroll in the FamilyCare program sponsored by Medicaid.

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.

Murphy further admitted that he is a self-employed contractor and the owner of A. Murphy Contracting. The investigation further determined that the income and profits Murphy received from that business far exceeded the $25,071 per year income limit necessary to qualify for FamilyCare.

State Investigators Michael English and Michael Behar and Deputy Attorney General Mark J. Ondris coordinated the investigation. DAG Ondris represented the Division of Criminal Justice - Office of Insurance Fraud Prosecutor at the guilty plea hearing. Mark Philips, Auditor with the State Division of Taxation, assisted in the investigation.

“While the Medicaid Fraud Section of the Office of the Insurance Fraud Prosecutor most often investigates and prosecutes Medicaid claim fraud, this case represents a prosecution where a person lied to obtain Medicaid health coverage,” Fraud Prosecutor Greta Gooden-Brown said. “This office will investigate allegations of persons lying about their eligibility for Medicaid coverage and will prosecute such persons in order maintain integrity within the Medicaid Program.”

Noting that some important cases have begun with anonymous tips from the public, Prosecutor Gooden-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 .”

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