TRENTON
- Division of Criminal Justice Director
Vaughn L. McKoy announced that an Essex
County man has been ordered to repay more
than $25,500 after 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,
was ordered by Essex County Superior Court
Judge Michael Ravin to pay more than $25,590
in restitution and to serve two concurrent
one-year probation terms. Judge Ravin
clarified that Murphy will serve probation
until the restitution has been paid back
in full. On June 29, Murphy pleaded guilty
to a criminal Accusation filed by the
Division of Criminal Justice. The Accusation
charged Murphy with Medicaid Fraud, and
failure to pay income taxes.
At the guilty plea hearing before Judge
Ravin, Murphy admitted that between May
30, 2001 and March 30, 2004, he wrongfully
obtained more than $16,000 in 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 Sept. 9 sentencing.
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
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.”
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