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New Jersey citizens at the center of massive Medicaid fraud case


Most of our New Jersey readers are probably familiar with Medicaid, a federal program that is designed to help people who have trouble paying for healthcare costs. The program is mostly designed to help those individuals and families whose incomes are well below the national average. That is why a recent report about an alleged scheme to file fraudulent claims that aimed to get the federal dollars that are available for reimbursement through this program is likely to get quite a bit of negative media attention.

According to reports, a 45-year-old New Jersey man and 12 others were recently implicated in a vast scheme in which the alleged perpetrators operated medical facilities at which they paid "kickbacks" to physicians to send patients for medical testing that was not necessary. Basically, the alleged scheme went like this: the suspects essentially bribed doctors to send people to the facilities for tests like MRIs, and the facilities then submitted the claims for reimbursement from the federal government under Medicaid. The result was reimbursements paid to the facilities, in the millions of dollars, that should never have been paid.

The reports indicate that the investigation into this alleged scheme involved a number of government agencies, with over 100 people working on it for nearly 18 months. But, to make things worse for the main suspect - the 45-year-old New Jersey man - this is not the first time he will be facing charges of Medicaid fraud: he was convicted on similar charges in 1998.

Planning a criminal defense strategy for charges of white collar crimes is never easy, but it would appear that the individuals involved in this case may have a much harder time than usually, due to the seemingly extensive nature of the investigation. For each of the 13 people who are alleged to be involved, the time to begin crafting a strategy is now.

Source: nj.com, "Alleged ringleader in NJ Medicaid fraud scheme arrested again," Seth Augenstein, June 19, 2014

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