TRENTON
Attorney General Anne Milgram and Division
of Criminal Justice Director Deborah L. Gramiccioni
announced that a Toms River dentist has pleaded
guilty to defrauding the Medicaid program
out of more than $75,000.
According to Acting Insurance
Fraud Prosecutor Riza Dagli, Christopher Lillo,
41, of Toms River, a licensed dentist employed
by New Jersey Mobile Dentist P.A. of Colts
Neck, pleaded guilty yesterday (July 30) before
Superior Court Judge Anthony J. Mellaci Jr.
in Monmouth County to an accusation that charged
him with third degree Medicaid fraud. The
charge stems from an ongoing investigation
by the Office of Insurance Fraud Prosecutor’s
Medicaid Fraud Control Unit.
In pleading guilty, Lillo
admitted that between Jan. 1, 2003, and March
6, 2009, as a Medicaid provider, he willfully
received medical assistance payments in an
amount greater than that to which he was entitled.
The investigation revealed that as a result
of the allegedly fraudulent billing, Medicaid
paid New Jersey Mobile Dentist P.A., who had
used Dr. Lillo’s Medicaid provider number,
over $300,000 to which it was not entitled.
New Jersey Mobile Dentist contracts with individual
dentists to provide "mobile" dental
services in various nursing homes and assisted
living facilities throughout New Jersey.
On July 17, 2009, Dr. Joshua
Prensky, another New Jersey Mobile Dentist
P.A. dentist, pleaded guilty to conspiracy
to commit Medicaid fraud. He is awaiting sentencing
in November.
Judge Mellaci scheduled sentencing
for Nov. 20. As part of his plea, Lillo agreed
to pay restitution and a civil penalty totaling
$277,298 to the State of New Jersey through
the Office of the Medicaid Inspector General,
which commenced operations in 2009 to investigate
fraud, waste and abuse in the Medicaid program.
In addition, the matter will be referred to
the Division of Consumer Affairs, which may
result in legal action against his professional
license.
Sgt. Kathleen Casey, Auditor
Kim Geis and Deputy Attorney General Debra
A. Conrad are assigned to the investigation.
Deputy Attorney General Conrad represented
the Office of Insurance Fraud Prosecutor at
the guilty plea hearing.
"These dentists exploited
a very vulnerable population; elderly and
disabled patients. Medical professionals are
given a tremendous amount of trust, and we
will continue to aggressively prosecute those
who take advantage of that trust," said
Acting Insurance Fraud Prosecutor Dagli. "Not
only do such Medicaid fraud schemes involve
theft of tax dollars, they also represent
a theft from a program designed to assist
persons who can not afford health insurance
or health care services."
Acting Prosecutor Dagli 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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