TRENTON - Attorney General
Paula T. Dow and Criminal Justice Director
Stephen J. Taylor announced that two co-owners
of a defunct Mercer County mental health
clinic have been sentenced for their roles
in a scheme to fraudulently over-bill the
Medicaid program by more than $125,000.
to Acting Insurance Fraud Prosecutor Riza
Dagli, Pedro Acosta, 65, of Queens, N.Y.,
co-owner of the now-defunct Chambers Mental
Health Clinic LLC, which was formerly located
in Trenton, was sentenced yesterday (Dec.
15) to three years in state prison and ordered
to pay $52,707 in restitution and the same
amount in civil penalties. Acosta’s
sentence was based on his May 2, 2008 guilty
plea to second-degree health care claims
fraud before Superior Court Judge Darlene
J. Pereksta in Mercer County.
yesterday, Osvaldo Morales Sr., 62, of Bronx,
N.Y., also a co-owner of Chambers Mental
Health Clinic LLC, was sentenced to three
years probation and ordered to pay $14,152
in restitution and the same amount in civil
penalties. Morales pleaded guilty on Jan.
27, 2010 to third-degree Medicaid fraud
before Superior Court Judge Edward M. Neafsey
in Mercer County. The charges were contained
in a Nov. 13, 2007 state grand jury indictment.
Acosta and Morales will
each be debarred from the Medicaid program
for eight years. Both defendants were sentenced
by Judge Neafsey.
In pleading guilty, Osvaldo
and Morales admitted that between January
2004 and November 2005, they fraudulently
over-billed the Medicaid program.
Two of Acosta and Morales’
co-defendants were previously sentenced:
Jacques, M.D., 61, of Jackson, the former
medical director of the clinic, a medical
doctor who practices as a psychiatrist –
was also charged in the Nov. 13, 2007 state
grand jury indictment. Jacques was sentenced
on Nov. 29 to three years in state prison
and ordered to pay a total of $49,941 restitution
to the Medicaid and Medicare programs. Jacques’
sentence was based on his Sept. 8 guilty
plea to second-degree conspiracy, second-degree
health care claims fraud, and third-degree
A third owner of Chambers
Mental Health Clinic LLC, Bernardo Estambul,
62, of New York, N.Y., previously pleaded
guilty to an accusation charging him with
Medicaid fraud and was subsequently sentenced
to three years probation and ordered to
pay $10,044 in fines and restitution. Estambul
was also barred from participating in the
Medicaid program for five years.
Morales, Estambul and Acosta
caused Medicaid claims to be billed under
Jacques’ Medicaid provider number
even though Jacques did not provide the
counseling services billed. In addition,
Morales, Estambul and Acosta billed Medicaid
for longer counseling sessions than those
that were actually provided. Medicaid pays
a higher rate for longer counseling sessions
and for counseling services provided by
a specialist medical doctor as opposed to
counselors who did not have licenses. The
defendants fraudulently billed the Medicaid
program for more than $125,000 to which
they were not entitled.
Joseph Jaruszewski and Kevin Gannon and
former Deputy Attorney General Sherry L.
Wilson were assigned to the investigation.
Deputy Attorney General Nina D. Bonner represented
the Office of the Insurance Fraud Prosecutor
at yesterday’s sentencing hearings.