| TRENTON
– Attorney General Stuart Rabner and
Division of Criminal Justice Director Gregory
A. Paw announced that a former licensed
family therapist pleaded guilty today to
submitting fraudulent health insurance claims.
According
to Insurance Fraud Prosecutor Greta Gooden
Brown, Evelyn S. Wilson, 65, of Englewood,
who formerly was licensed in New Jersey
as a clinical social worker and a marriage
and family therapist, pleaded guilty to
third-degree theft by deception before Superior
Court Judge Lois Lipton in Bergen County.
On April 14, Wilson surrendered her two
professional licenses to the state boards
that license social workers and family counselors.
At
the guilty plea hearing, Wilson admitted
that between Aug. 20, 2001 and June 16,
2004, she submitted insurance claims to
Horizon Blue Cross and Blue Shield for social
work, marriage counseling and family therapist
services that were never rendered to patients
or clients. An investigation determined
that Wilson submitted claims for several
hundred therapy sessions that did not take
place. Wilson used her residence as her
place of business.
Crimes
of the third degree carry a sentence of
up to five years in state prison and a criminal
fine of up to $15,000. Wilson may also face
civil insurance fraud fines.
State
Investigator Abraham Aquino, Civil Investigator
Martin Arasin and Deputy Attorney General
Cheryl A. Maccaroni handled the case.
“When
health care providers commit fraud, it is
particularly disturbing because the integrity
of the health care insurance claims process
depends on the trustworthiness of the licensed
professionals involved,” said Insurance
Fraud Prosecutor Brown.
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