- Attorney General Jeffrey S. Chiesa announced
that a Monmouth County dentist has been indicted
for allegedly submitting false claims to the
Cai, 49, of Holmdel, a licensed dentist
whose practice is located in Hazlet, was
charged with second-degree health care claims
fraud and two counts of third-degree Medicaid
Monmouth County grand jury indictment alleges
that between Jan.1, 2007 and Jan.1, 2010,
Cai fraudulently billed the Medicaid Program
for dental service purportedly rendered
to Medicaid recipients. It is alleged that
Cai submitted fraudulent claims for payment
from Medicaid for relining and rebasing
of dentures and filling of cavities when
those dental services were not rendered.
An investigation by the Office of the Insurance
Fraud Prosecutor’s Medicaid Fraud
Control Unit determined that, as a result
of alleged fraud, Cai was allegedly paid
more than $39,000 by Medicaid for the services
that were not rendered.
Attorney General Linda A. Rinaldi and Detective
Ralph Anilo were assigned to the investigation.
Rinaldi presented the case to the Monmouth
County grand jury.
indictment, which was voted on Jan. 23 but
handed up yesterday, 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 Insurance Fraud Prosecutor
Ronald Chillemi thanked Medicaid for referring
the matter to the Office of the Insurance
Insurance Fraud Prosecutor Chillemi 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 at 1-877-55-FRAUD,
or visiting the Web site at www.NJInsurancefraud.org.
State regulations permit a reward to be
paid to an eligible person who provides
information that leads to an arrest, prosecution
and conviction for insurance fraud.