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TRENTON - Attorney General
Anne Milgram announced that the co-owner
of two pharmacies in East Orange and Jersey
City pleaded guilty today to overbilling
Medicaid by hundreds of thousands of dollars
for HIV/AIDS drugs that were never dispensed.
The other owner of the pharmacies pleaded
guilty last week.
According to Insurance Fraud
Prosecutor Greta Gooden Brown, John Borges,
44, of Piscataway, co-owner of MLK Pharmacy
on M.L.K Drive in Jersey City and Ampere
Pharmacy on 4th Avenue in East Orange, pleaded
guilty today before Superior Court Judge
Michael A. Petrolle in Essex County to an
accusation charging him with second-degree
health care claims fraud and third-degree
filing a false or fraudulent New Jersey
income tax return.
Under his plea agreement,
Borges faces a sentence of three years in
state prison. He must pay $500,000 in restitution
and will forfeit more than $260,000 in funds
seized from him by the state.
On Aug. 19, the other owner
of the pharmacies, Abdul Bari, 53, of Nutley,
pleaded guilty to the same charges before
Superior Court Judge Kevin G. Callahan in
Hudson County. He also faces a three-year
prison sentence under his plea agreement.
Bari must forfeit approximately $300,000
in assets seized from him by the state,
and pay an additional $327,000.
The two men admitted that
between January 2005 and October 2007, they
fraudulently submitted bills to Medicaid
for HIV/AIDS drugs that were never dispensed.
They admitted that they purchased prescriptions
from Medicaid participants for a small fraction
of the cost of the drugs prescribed, and
in turn billed Medicaid thousands of dollars
without dispensing the drugs. An investigation
led by the Medicaid Fraud Control Unit of
the Office of Insurance Fraud Prosecutor
revealed that the two pharmacies overbilled
Medicaid by hundreds of thousands of dollars.
Additionally, both Borges
and Bari admitted that they caused fraudulent
personal income tax returns to be submitted
to the New Jersey Division of Taxation for
tax years ending in 2004 through 2006.
Borges is scheduled to be
sentenced on Oct. 6 by Judge Petrolle. Bari
is scheduled to appear before Judge Callahan
on Oct. 10 to be sentenced.
Detectives Kevin Gannon
and Joseph Jaruszewski were assigned to
the investigation, along with Deputy Attorney
General Erik W. Daab. Deputy Attorney General
Daab represented the Office of Insurance
Fraud Prosecutor at the guilty plea hearings.
Sgt. James Wrightson and Deputy Attorney
General Carol Stanton Meier were assigned
to the asset forfeiture case. The Jersey
City Police Department also assisted in
this investigation. Prosecutor Brown thanked
the Jersey City Police Department for their
valuable assistance.
“By defrauding the
Medicaid program, these defendants not only
stole tax dollars, they stole from a program
dedicated to providing health care coverage
for persons who otherwise could not afford
it,” said Insurance Fraud Prosecutor
Brown. “Our investigation into this
type of Medicaid fraud is ongoing.”
Prosecutor
Brown noted that some important cases have
started with anonymous tips. People who
are concerned about insurance cheating and
have information about a fraud can report
it anonymously by calling the toll-free
hotline 1-877-55-FRAUD or visiting the Web
site www.njinsurancefraud.org.
State regulations permit an award to be
paid to an eligible person who provides
information that leads to an arrest, prosecution
and conviction for insurance fraud.
The Office of Insurance
Fraud Prosecutor was established by the
Automobile Insurance Cost Reduction Act
of 1998. The office is the centralized state
agency that investigates and prosecutes
both civil and criminal insurance fraud,
as well as Medicaid fraud.
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