TRENTON
- Attorney General Paula T. Dow and Criminal
Justice Director Stephen J. Taylor announced
that the owner of an Essex County home health
care agency and his wife pleaded guilty
yesterday (Aug. 4) for their roles in a
scam to defraud the Medicaid program out
of $800,000.
According
to Acting Insurance Fraud Prosecutor Riza
Dagli, Olasehmdeme (also known as Isaac)
Arowosaye, 53, of West Orange, the owner
and operator of Be Kind Health Care Services,
LLC, located in Orange, pleaded guilty before
Superior Court Judge Sherry Hutchins-Henderson
in Essex County to an accusation which charged
him with second-degree health care claims
fraud.
Arowosaye’s
wife, Emily Arowosaye, 43, also of West
Orange, the vice president of Be Kind Health
Care Services and also the nurse supervisor,
pleaded guilty before Judge Hutchins-Henderson
to an accusation charging her with third-degree
Medicaid fraud.
The
guilty pleas were a result of a cooperative
investigation by the Medicaid Fraud Control
Unit of the Office of the Insurance Fraud
Prosecutor and the Office of the State Comptroller
– Medicaid Fraud Division. Olasehmdeme
Arowosaye was arrested on April 26 as a
result of the investigation and is currently
free on $150,000 bail.
Judge
Hutchins-Henderson scheduled sentencing
for Sept. 13. Under the plea agreement,
the state will recommend a sentence of three
years in state prison for Olasehmdeme Arowosaye
and a probationary sentence for Emily Arowosaye.
The defendants also signed a consent agreement
agreeing to pay $800,000 in restitution
to the Medicaid program. In addition, the
defendants agreed to pay an $800,000 civil
penalty and to be debarred from the Medicaid
program for five years.
In
pleading guilty, Isaac and Emily Arowosaye
admitted that between July 2005 and April
2008, they submitted fraudulent claims to
the Medicaid program for personal care assistance
services purportedly provided to Medicaid
beneficiaries when, in fact, the services
were not provided.
An investigation by the Office of the Insurance
Fraud Prosecutor’s Medicaid Fraud
Control Unit revealed that, as well as billing
for services not rendered, the Arowosayes
fraudulently billed the Medicaid program
by falsely billing for services during weekend
hours when services were not rendered on
the weekend; submitting claims with forged
doctors’ signatures; billing for more
hours of service than were actually rendered;
billing for services for patients who were
dead when the services were purportedly
rendered; billing for services for patients
who were in hospitals at the time the company
claimed to have provided services; billing
for services by unlicensed home health aides
as if licensed home health aides had provided
the services; and billing for medical services
that were not medically necessary nor authorized
by a physician.
On
July 30, , 28, of Orange,
who was in charge of Be Kind Health Care
Services’ payroll, pleaded guilty
to third-degree theft by deception. In pleading
guilty, admitted that between March
and September 2008, she stole more than
$13,200 in unemployment assistance payments
from the New Jersey Department of Labor
and Workforce Development by falsely representing
that she was unemployed, while she was actually
receiving wages from Be Kind Health Care
Services.
On
June 22, Christine Lamour, 27, of East Orange,
who was the case manager employed by Be
Kind Health Care Services, pleaded guilty
to third-degree theft by deception. In pleading
guilty, Lamour admitted that between March
2008 and March 2010, she stole more than
$23,700 in unemployment assistance payments
from the New Jersey Department of Labor
and Workforce Development by falsely representing
that she was unemployed, while she was actually
receiving wages from Be Kind Health Care
Services.
and Lamour are pending sentencing.
Sergeant
Warren Monroe and Deputy Attorney General
Debra Conrad were assigned to the investigation.
Additional assistance was provided by Matthew
Bernal. Deputy Attorney General Conrad represented
the Office of the Insurance Fraud Prosecutor
at the guilty plea hearings. Deputy Attorney
General Carol Stanton Meier, Detective Sgt.
Scott Naismyth and Analyst Bethany Schussler
are handling the asset forfeiture action
for the Division of Criminal Justice. Acting
Insurance Fraud Prosecutor Dagli thanked
the Office of the State Comptroller - Medicaid
Fraud Division for its assistance in the
investigation, specifically Investigators
Rita Smith and Glenn Geib.
“Abuse
of the Medicaid program and insurance fraud
by persons who hold professional licenses
are particularly disturbing crimes,”
said Acting Insurance Fraud Prosecutor Dagli.
“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 cannot afford health
insurance or health care services. Such
cases are a priority for the Office of the
Insurance Fraud Prosecutor.”
The Office of the 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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