TRENTON
- Attorney General Paula T. Dow and Criminal
Justice Director Stephen J. Taylor announced
that the owner of a now-defunct Newark mental
health and substance abuse counseling center
has been indicted for allegedly defrauding
Medicaid of hundreds of thousands of dollars.
According
to Acting Insurance Fraud Prosecutor Riza
Dagli, Rostislav Vilshteyn, a.k.a. Steve
Vilshteyn, 31, of Staten Island, New York,
was charged yesterday (May 11) with second-degree
health care claims fraud and two counts
of third-degree Medicaid fraud.
The
state grand jury indictment alleges that
between October 2006 and January 2008, as
the owner and operator of Bloomfield Health
Pavilion LLC, formerly located at 86 Bloomfield
Avenue in Newark, Vilshteyn submitted or
caused to be submitted to the Medicaid program
claims for reimbursement for health care
or counseling services for numerous Medicaid
beneficiaries, even though the services
had either not been provided or had not
been provided to the extent alleged in the
claims.
The
investigation revealed that Vilshteyn submitted
more than $1.2 million in claims to the
Medicaid program, for which he was paid
$574,504. It is alleged that hundreds of
thousands of dollars of those payments were
obtained by Vilshteyn through fraudulent
claims.
The
indictment further alleges that Vilshteyn
offered “kickbacks” in the form
of Pathmark gift certificates in order to
induce Medicaid beneficiaries to appear
at Bloomfield Health Pavilion. He allegedly
submitted fraudulent claims related to those
beneficiaries. One of the counts of Medicaid
fraud is charged under the state’s
“anti-kickback” statute.
Detective Laura Pezzuti and Deputy Attorney
General Cynthia M. Vazquez were assigned
to the investigation. Deputy Attorney General
Vazquez presented the case to the state
grand jury. Acting Prosecutor Dagli thanked
Investigator Joseph Varone and Nurse Investigator
Janet Keenan of the Office of the Medicaid
Inspector General, as well as Analyst James
Harris of the Division of Medical Assistance
and Health Services for their assistance
in the investigation.
The
indictment is merely an accusation and the
defendant is presumed innocent until proven
guilty. Second-degree crimes carry a maximum
sentence of 10 years in state prison and
a criminal fine of $150,000, while the crime
of third-degree Medicaid fraud carries a
maximum sentence of three years in state
prison and a criminal fine of $10,000.
Acting
Fraud 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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