Global Navigation
Office of The Attorney General
The State of New Jersey Office of The Attorney General (Dept. of Law & Public Safety) The State of New Jersey NJ Home Services A to Z Departments/Agencies OAG Frequently Asked Questions
Services A to Z Departments/Agencies OAG Frequently Asked Questions
OAG Home
OAG Contact
Back to News Releases
OAG Home Attorney General's Biography
Attorney General's Biography
spacer spacer spacer
 
spacer spacer spacer
spacer spacer spacer
For Immediate Release:
For Further Information:
spacer spacer spacer

January 21, 2011

Office of The Attorney General
- Paula T. Dow, Attorney General
Division of Criminal Justice
- Stephen J. Taylor, Director

Office of the Insurance Fraud Prosecutor
- Riza Dagli, Acting Insurance Fraud Prosecutor

Media Inquiries-
609-292-4791
Citizen Inquiries-
609-292-4925

spacer
spacer spacer spacer
spacer

Owner of Totowa Nursing Home Sentenced for Billing Medicaid Program for More than $100,000 in Personal Expenses
Fraud investigated by Attorney General’s Office and Department of Health & Senior Services

spacer
spacer spacer spacer
spacer

TRENTON - Attorney General Paula T. Dow and Criminal Justice Director Stephen J. Taylor announced that the owner of a Totowa nursing home was sentenced today for fraudulently obtaining payment from the Medicaid Program. A state investigation revealed that he billed the Medicaid program for $302,877 in improper and unsubstantiated costs, including more than $100,000 in personal expenses.

According to Acting Insurance Fraud Prosecutor Riza Dagli, Victor Napenas, 64, of Piscataway, was sentenced to 30 days in county jail as a condition of three years probation by Superior Court Judge Irvin J. Snyder in Camden County. In addition, Napenas must pay $302,877 in restitution to the Medicaid program, $45,263 in penalties, and $31,859 in provider taxes owed to the state. He will be prohibited from acting as a Medicaid provider for eight years.

The sentence was based on Napenas’ Aug. 16 guilty plea to an accusation charging him with third-degree Medicaid fraud. Napenas owned the Valley Rest Nursing Home on Bogart Street in Totowa, which closed in 2007. In pleading guilty, he admitted that he fraudulently obtained payments from Medicaid for personal expenses unrelated to patient care.

The investigation began when Department of Health and Senior Services (DHSS) surveyors noted severe deficiencies in the care delivered to residents at Valley Rest, which resulted in the owners voluntarily closing the facility in 2007. In the process, DHSS ordered a financial audit, which showed many irregularities on the facility's 2005 cost report submitted to Medicaid.

DHSS referred the matter to the Division of Criminal Justice. The Office of the Insurance Fraud Prosecutor’s Medicaid Fraud Control Unit worked closely on this investigation with DHSS, in particular the Department’s Director of Nursing Facility Rate Setting.

The investigation revealed that the cost report included $302,877 in improper charges, including personal expenses and other amounts Napenas could not document or prove were spent.

Napenas issued business credit cards to himself and his wife through the nursing home, which they used for personal purchases, including trips to the Philippines, dance lessons and large family dinners. Napenas had those credit card charges and other personal expenses totaling more than $100,000 inserted into the cost report, resulting in reimbursement from Medicaid.

“This nursing home owner treated the facility’s Medicaid cost report like his own blank check, fraudulently obtaining reimbursement for over $100,000 in personal expenses in a single year,” said Acting Insurance Fraud Prosecutor Dagli. “Fortunately, the Department of Health and Senior Services audited the facility and detected irregularities in the cost report. Our Medicaid Fraud Control Unit will continue to work with the Department of Health and Senior Services to uncover and prosecute fraud and abuse involving Medicaid providers.”

Deputy Attorney General Linda A. Rinaldi represented the Office of the Insurance Fraud Prosecutor at the sentencing. The case was prosecuted by Deputy Attorney General Rinaldi and Deputy Attorney General Erik Daab, Director of the Medicaid Fraud Control Unit. Sgt. Frederick Weidman, Auditor Kim Geis and Deputy Attorney General Rinaldi conducted the investigation for the Office of the Insurance Fraud Prosecutor.

Attorney General Dow thanked DHSS Director of Rate Setting Devon Graf for the referral and the extensive assistance of his unit throughout the investigation. She also thanked Supervising Investigator Joe Marty of the Division of Taxation for his assistance.

The Medicaid program, which is funded by the state and federal governments, provides health care services and prescription drugs to persons who may not otherwise be able to afford them. The State of New Jersey administers the Medicaid program through the Division of Medical Assistance and Health Services in the Department of Human Services and through the Office of the Insurance Fraud Prosecutor’s Medicaid Fraud Control Unit, which investigates both criminal and civil Medicaid fraud and abuse in that program.

Anyone with information about fraud or abuse involving the Medicaid program or Medicaid providers is urged to call the Medicaid Fraud Control Unit toll free at 1-877-55-FRAUD or visit www.NJInsuranceFraud.org. All information received will remain confidential.

###

spacer
spacer spacer spacer
spacer
 
 
Contact OAG About OAG
OAG News OAG Frequently Asked Questions
OAG Library Employment
OAG Grants Proposed Rules
OAG History OAG Services A-Z
OAG Agencies / Programs / Units
Other News Pages Otras Noticias en Español Division of NJ State Police Division of Law News Governor's Office News Division of Highway Traffic Safety News Office of the Insurance Fraud Prosecutor Juvenile Justice Commission News Division on Civil Rights News Division of Consumer Affairs News Division of Criminal Justice News Election Law Enforcement Commission Division of Gaming Enforcement News
NJ State Police News Governor's Office News Division of Highway Traffic Safety News Office of the Insurance Fraud Prosecutor Juvenile Justice Commission News Division on Civil Rights News Division of Consumer Affairs News Division of Criminal Justice News Election Law Enforcement Commission Division of Elections News Division of Gaming Enforcement News Office of Government Integrity News

free PDF plugin

NJ State Police News Governor's Office News Division of Highway Traffic Safety News Office of the Insurance Fraud Prosecutor Juvenile Justice Commission News Division on Civil Rights News Division of Consumer Affairs News Division of Criminal Justice News Election Law Enforcement Commission Division of Elections News Division of Gaming Enforcement News Office of Government Integrity News
 
   
Contact Us | Privacy Notice | Legal Statement | Accessibility Statement
NJ Home Logo
Departmental: OAG Home | Contact OAG | About OAG | OAG News | OAG FAQs
Statewide: NJ Home | Services A to Z | Departments/Agencies | FAQs
Copyright © State of New Jersey
This page is maintained by OAG Communications. Comments/Questions: email or call 609-292-4925
OAG Home OAG Home NJ State Police News Governor's Office News Division of Highway Traffic Safety News Office of the Insurance Fraud Prosecutor Juvenile Justice Commission News Division on Civil Rights News Division of Consumer Affairs News Division of Criminal Justice News Election Law Enforcement Commission Division of Elections News Division of Gaming Enforcement News Office of Government Integrity News