Rashmi Gupta, 39, of Paramus, pleaded guilty to an accusation charging her with third-degree Medicaid fraud before Superior Court Judge Marilyn Clark in Passaic County.

Judge Clark scheduled sentencing for June 22. Under the plea agreement, the Office of the Insurance Fraud Prosecutor will recommend that Gupta be sentenced to probation. In addition, Gupta will be debarred from Medicaid for a period of five years. The matter is being referred to the New Jersey Board of Social Work Examiners for possible action against Gupta's license to practice social work in New Jersey.

In pleading guilty, Gupta, a licensed social worker previously employed by The Youth Success Network (TYSN) in Passaic, admitted that between July 24 and December 22, 2010, she submitted her time sheets for in-community counseling services to TYSN, when those services were not provided to the extent claimed. TYSN submitted claims to the Medicaid program and compensated Gupta in the amount of $10,177.50, based on Gupta’s fraudulent time sheets.

“Abuse of the Medicaid program and insurance fraud by persons who hold professional licenses are disturbing crimes,” said Acting Insurance Fraud Prosecutor Ronald Chillemi. “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. Such cases are a priority for the Office of the Insurance Fraud Prosecutor.”

New Jersey law provides that there is a presumption against any sentence of incarceration for a person convicted of a third-degree crime who has not previously been convicted of an indictable offense.

Deputy Attorney General Dolores Blackburn, Medicaid Fraud Control Unit Acting Chief Nicole Rizzolo and Detective Luisa Sanchez were assigned to the case. The matter was referred to the Office of the Insurance Fraud Prosecutor by TYSN after it was notified by a client that Gupta was not providing the required services.

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