TRENTON
- Attorney General Paula T. Dow, Criminal
Justice Director Stephen J. Taylor and Medicaid
Inspector General Mark Anderson announced
the arrest today of the owner of a home
health care agency in Orange on charges
he submitted a false application to become
a Medicaid provider and fraudulently billed
Medicaid for services that were never rendered
or that were authorized with forged physician
signatures. It is alleged that his company,
Be Kind Health Care Services Inc., fraudulently
billed Medicaid nearly $5 million.
According
to Acting Insurance Fraud Prosecutor Riza
Dagli, Olasehmdeme “Isaac” Arowosaye,
53, of West Orange, was arrested as the
result of a cooperative investigation by
the Medicaid Fraud Control Unit of the Office
of the Insurance Fraud Prosecutor and the
New Jersey Office of the Medicaid Inspector
General. He was charged with second-degree
health care claims fraud, third-degree Medicaid
fraud and third-degree tampering with public
records or information.
Detectives
and investigators of the Division of Criminal
Justice and the Office of the Medicaid Inspector
General arrested Arowosaye today near his
home. They also executed a search warrant
and seized records at the offices of Be
Kind Health Care Services at 289 Reynolds
Terrace in Orange. Arowosaye was lodged
in the Essex County Jail in lieu of $150,000
bail.
“We
charge that this defendant, through his
home health care company, repeatedly submitted
fraudulent claims to Medicaid, including
bills for patients who were deceased or
in the hospital at the time he claimed to
have provided them services in their homes,”
said Attorney General Dow. “We have
zero tolerance for Medicaid fraud, which
costs New Jersey’s Medicaid program,
and the state and federal taxpayers who
fund it, millions of dollars every year.”
“This
office simply will not tolerate somebody
seeking to game the system as Mr. Arowosaye
tried to do. Today is a good example of
how working with our state partners will
improve the integrity of the Medicaid Program
and protect precious state dollars,”
said Medicaid Inspector General Anderson.
Be
Kind Health Care Services is owned by Arowosaye
and his wife, a registered nurse. The company
employs personal care assistants to provide
services such as bathing, medical care and
assistance with everyday activities to incapacitated
patients in their homes.
Be
Kind Health Care Services billed Medicaid
a total of $4,970,359 for services purportedly
rendered between July 2005 and July 2008.
However, the investigation revealed that
Arowosaye, who is CEO of the company, and
Be Kind Health Care Services allegedly billed
Medicaid for services that were never rendered,
as well as services that were not medically
necessary and were authorized by Medicaid
based on forged documents.
“Every
dollar lost to fraud is one less dollar
available to provide much-needed health
care services and medicines to residents
who otherwise could not afford them,”
said Acting Insurance Fraud Prosecutor Dagli.
“We will continue to work cooperatively
with the Office of the Medicaid Inspector
General to aggressively investigate and
prosecute Medicaid fraud.”
The
investigation began when the Office of the
Medicaid Inspector General conducted an
audit of Medicaid claims submitted by Be
Kind Health Care Services and discovered
numerous discrepancies. The Office of the
Medicaid Inspector General commenced a full
investigation and also referred the matter
to the Division of Criminal Justice.
It
is alleged that Be Kind Health Care Services
billed Medicaid for at least a dozen patients
who, in fact, were dead when the services
were purportedly rendered. The company also
allegedly billed Medicaid for about 30 patients
who were in hospitals at the time the company
claimed to have provided services. While
patients are hospitalized, hospital nurses
provide all of their care.
It
is also alleged that Be Kind Health Care
Services allegedly forged the signatures
of a number of doctors on Medicaid forms
to make it appear that the doctors authorized
services provided by Be Kind Health Care
Services. As a result, the company allegedly
obtained payment for services which had
not actually been authorized by a physician
as required by the Medicaid program.
In
addition, it is alleged that Be Kind Health
Care Services became a Medicaid provider
as a result of an application submitted
by Arowosaye in 2005 in which he used a
false identity and gave other false information.
It is alleged that all of the nearly $5
million in payments that Be Kind Health
Care Services received from Medicaid were
obtained by fraud, because Arowosaye gave
a false answer to a material question on
the application that, if answered truthfully,
would have prevented the company from being
approved as a Medicaid provider.
The
state will seek full restitution from the
company and Arowosaye. The Division of Criminal
Justice is filing an asset forfeiture case
today seeking to seize assets of Arowosaye.
The
investigation was conducted and coordinated
for OIFP’s Medicaid Fraud Control
Unit by Sgt. Warren Monroe, Deputy Attorney
Debra Conrad, and Deputy Attorney General
Erik Daab, who is Deputy Chief Counsel of
the Medicaid Fraud Control Unit. Deputy
Attorney General Carol Stanton Meier, Detective
Sgt. Scott Naismyth and Analyst Bethany
Schussler are handling the asset forfeiture
action for the Division of Criminal Justice.
Second-degree
crimes carry a maximum sentence of 10 years
in state prison and a criminal fine of $150,000.
Third-degree Medicaid fraud carries a maximum
sentence of three years in state prison
and a criminal fine of $10,000. Third-degree
crimes carry a maximum sentence of five
years in prison and a $75,000 fine.
The
charges are merely accusations and the defendant
is presumed innocent until proven guilty.
Because the charges are indictable offenses,
the allegations must be presented to a state
grand jury for potential indictment.
If
anyone has information about fraud or abuse
involving the Medicaid program or Medicaid
providers, they are urged to contact the
Medicaid Fraud Control Unit by calling the
toll-free hotline 1-877-55-FRAUD
or visiting the Web site www.NJInsuranceFraud.org.
All information received through the hotline
or Web site will remain confidential.
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