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TRENTON
- Attorney General Anne Milgram and Criminal
Justice Director Deborah L. Gramiccioni announced
that a New York man was indicted today for
billing the Medicaid program for services
he did not perform.
According
to Insurance Fraud Prosecutor Greta Gooden
Brown, Mark Darby, 40, of the Bronx, N.Y.,
was charged with second-degree health care
claims fraud and third-degree Medicaid fraud.
The state grand jury indictment alleges that
between Jan. 12 and Aug. 6, 2007, Darby, who
was a behavioral services counselor for Innovative
Specialists Inspirational Solutions, submitted
timesheets to his employer containing false
information. In submitting the false timesheets,
Darby allegedly claimed that that he provided
$4,173 worth of hourly behavioral assistance
services to four Medicaid recipients when,
in fact, he had not provided those services.
ISIS suspected the fraud and referred the
matter to the Office of Insurance Fraud Prosecutor
for further investigation. ISIS fired Darby
as a result of an internal investigation.
Detective Jessica Nelan and Deputy Attorney
General Cynthia Vazquez were assigned to the
investigation. Deputy Attorney General Vazquez
presented the case to the state grand jury.
The
indictment is merely an accusation and the
defendant is presumed innocent until proven
guilty. Under state law, second-degree crimes
carry a maximum sentence of 10 years in state
prison and a criminal fine of $150,000, while
third-degree Medicaid Fraud carries a maximum
sentence of three years in state prison and
a criminal fine of $10,000.
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