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TRENTON
- Attorney General Anne Milgram and Criminal
Justice Director Gregory A. Paw announced
today that three North Jersey residents
and a Newark home health care agency were
charged in a state grand jury indictment
with fraudulently billing the Medicaid program
nearly $1 million for services that were
never rendered or were ineligible for Medicaid
reimbursement.
According
to Insurance Fraud Prosecutor Greta Gooden
Brown, the state grand jury indictment handed
up late yesterday charges:
-
Kimberly D. Hall,
aka Kim Hall, aka Kim Turner, 48, Scotch
Plains. Charged with three counts of second-degree
health care claims fraud, as well as one
count each of second-degree conspiracy
and third-degree Medicaid fraud;
- Willie
T. Cureton,
aka William T. Curaton, aka Willie Curation,
38, Newark. Charged with two counts of
second-degree health care claims fraud,
as well as one count each of second-degree
conspiracy and third-degree Medicaid fraud;
- Ollie
Sabrina Kimble,
aka Sabrina Kimble, 42, also of Newark.
Charged with health care claims fraud
and conspiracy (both in the second-degree).
- Touch
of Life Home Health Care Agency,
LLC, doing business at 61 Chelsea Avenue,
Newark. Charged with two counts each of
second-degree health care claims fraud
and third-degree Medicaid Fraud as well
as one count of second-degree conspiracy.
The
indictment alleges that between March 2003
and May 2004, the defendants submitted nearly
$1 million in fraudulent bills to the Medicaid
program. Hall and Cureton owned and operated
Touch of Life Home Health Agency, and Kimble
was an office coordinator who allegedly
assisted Hall and Cureton by directing personal
care assistants to fill out fraudulent time
sheets.
Touch
of Life provided assistance to patients,
including services provided by personal
care assistants and home health aids. Personal
care assistants and home health aids provide
day-to-day assistance to patients who are
otherwise unable to care for themselves,
including dressing and feeding patients,
taking care of homes, assisting with the
taking of medicines and related responsibilities.
The
indictment charges that Touch of Life billed
Medicaid for personal care assistant services
which were rendered at Class C boarding
homes and residential health care facilities.
Medicaid regulations do not permit billing
for personal care assistants and home health
aides services in Class C boarding homes
and residential health care facilities because
such facilities are already paid for by
the State for personal care services for
the residents.
The
indictment also alleges that Touch of Life
billed the Medicaid Program for 6,946 hours
of personal care assistants and related
services more than were actually provided.
The
indictment alleges that Hall billed the
Medicaid Program for services purportedly
provided by her as a personal care assistant
when, in fact, her personal care assistant’s
license had been revoked in November 2003.
The indictment also alleges that Hall lied
on her application to become a Medicaid
provider.
Altogether,
the defendants billed a total of 62,755
hours for services not provided or in violation
of Medicaid regulations.
State
Investigators Jacqueline Latty and Charles
Wells, Auditor Kim Geis, and Deputy Attorneys
General Riza Dagli and Linda Rinaldi were
assigned to the investigation. Dagli and
Rinaldi presented the case to the state
grand jury
AIt
is particularly disturbing when persons
who hold professional licenses steal from
the Medicaid program,” said Insurance
Fraud Prosecutor Greta Gooden Brown. ANot
only do they steal tax dollars, they steal
funds intended to assist persons who cannot
afford health insurance or health care services.
Such cases are a priority for the Office
of Insurance Fraud Prosecutor."
The
indictment was handed up to Superior Court
Judge Charles A. Delehey in Mercer County.
The indictment is merely an accusation and
the defendants are presumed innocent until
proven guilty. The case was assigned to
Essex County, where the defendants will
be ordered to appear at a later date.
Second-degree
crimes carry a maximum punishment of 10
years in state prison and a criminal fine
of $150,000. Third-degree Medicaid fraud
carries a maximum punishment of three years
in state prison and a criminal fine of $10,000.
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