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TRENTON
– A Mahwah man admitted today to stealing
more than $139,000 in health insurance benefits
from the NJ FamilyCare Program by underreporting
his income on applications to make it falsely
appear that his family was eligible for
the program, Attorney General Anne Milgram
announced.
NJ
FamilyCare is a state and federally-funded
Medicaid health insurance program created
to help New Jersey’s uninsured children
and certain low-income parents and guardians
obtain affordable health coverage. The plea
resulted from an investigation by the Division
of Criminal Justice and the Division of
Taxation.
The
plea is the first to come from referrals
made to the Division of Criminal Justice
by the Department of Human Services, which
administers NJ FamilyCare through its Division
of Medical Assistance and Health Services.
The referrals stemmed from an audit of the
program conducted by the New Jersey Legislature’s
Office of the State Auditor between 2005
and 2007.
John
Dawli, 52, of Mahwah, pleaded today to an
accusation charging him with third-degree
theft by deception before Superior Court
Judge Gerald J. Council in Mercer County
and will enter the Pre-Trial Intervention
Program. Dawli admitted that between March
2003 and August 2008, he received $139,713
in NJ FamilyCare benefits for his four children
for which the family was not eligible. Dawli’s
average income was about $110,000 per year
from 2003 through 2007, but he reported
less than half of that income on NJ FamilyCare
applications in order to appear eligible
for the program.
“The
NJ FamilyCare Program is designed to help
children and families who otherwise would
be left without vital health care services
and medicines,” said Attorney General
Milgram. “When individuals who can
afford coverage instead misrepresent their
income as this defendant did, there is less
funding available to serve those in need.
We will continue to prosecute those who
cheat the program and make them pay for
any benefits received.”
The
theft charge carries a sentence of three
to five years in state prison and a fine
of up to twice the amount stolen. However,
under the plea agreement, the state did
not oppose Dawli’s application to
the court for the Pre-Trial Intervention
Program, conditioned upon Dawli paying full
restitution to NJ FamilyCare and otherwise
complying with the agreement.
Attorney
General Milgram credited Deputy Attorney
General Viktoria Kristiansson for prosecuting
the case and taking the guilty plea. She
credited Lt. John C. Jespersen of the Division
of Criminal Justice Major Crimes Bureau
and Auditor Thaedra Chebra of the Division
of Taxation in the Department of the Treasury
for conducting the investigation with Kristiansson.
Attorney
General Milgram also credited the Office
of the State Auditor for its audit, and
thanked the Department of Human Services
for referring the case and assisting in
the investigation.
NJ
FamilyCare provides free or low-cost health
insurance – often with premiums and
co-payments – to uninsured children
and certain qualified parents. Children
can be eligible in families earning up to
350 percent of the federal poverty level,
which is $74,000 for a family of four. Enrollment
is based on household income, and can include
income from self-employment, corporations
and partnerships, rent, interest, dividends
and other non-work income. Eligibility for
enrollment must be re-determined every 12
months.
Dawli
paid a total of $1,722 in premiums during
the period in question.
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