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TRENTON
– A Bergen County man admitted today
to stealing more than $86,000 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 and Criminal
Justice Director Deborah L. Gramiccioni
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 third 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.
According
to Director Gramiccioni, Mohan Tilani, 50,
of Closter, pleaded today to an accusation
charging him with third-degree theft by
deception before Superior Court Judge Thomas
P. Kelly in Mercer County and will enter
the Pre-Trial Intervention Program.
Tilani
admitted that between 2002 and 2008, he
received $86,458 in NJ FamilyCare benefits
for himself, his wife, and their three children,
currently 15 to 22 years of age, for which
the family was not eligible. Tilani’s
average income was about $200,000 per year
from 2002 through 2007, but he reported
only a small fraction 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 Tilani’s application to
the court for the Pre-Trial Intervention
Program, conditioned upon Tilani 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 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.
They were assisted by Donna Torlini, Project
Manager in the Office of Contract Compliance
for the Division of Medical Assistance and
Health Services, Department of Human Services.
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.
Tilani
paid a total of $4,702 in premiums during
the period in question.
On
Oct. 23, John Dawli, 52, of Mahwah, pleaded
to an accusation charging him with third-degree
theft by deception. He also entered the
Pre-Trial Intervention Program, conditioned
on payment of full restitution. 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.
On
Nov. 5, Rajesh Desai, 49, of Woodcliff Lake,
pleaded to an accusation charging him with
third-degree theft by deception. He also
entered the Pre-Trial Intervention Program,
conditioned on payment of full restitution.
Desai admitted that between October 2005
and August 2008, he received $49,383 in
NJ FamilyCare benefits for himself, his
wife, and their two children for which the
family was not eligible. Desai’s average
income was about $260,000 per year from
2005 through 2007, but he reported annual
income ranging from $6,669 to $31,200 for
those three years on NJ FamilyCare applications.
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