A West New York business owner who sold medical equipment supplies has pleaded guilty to a $101,000 Medicaid fraud scam, Attorney General Christopher Porrino announced.
By John Heinis/Hudson County View
Alfredo Valdes, Jr., 42, of Clifton, pleaded guilty to second-degree charges of health care claims fraud and theft by deception in a hearing before Hudson County Superior Court Judge Mitzy Galis-Menendez yesterday.
Under the terms of the plea agreement, the state will recommend that Valdes, who owns T-N-T medical supplies in West New York, be sentenced to four years in state prison.
Valdes will also pay $101,000 in restitution to Horizon New Jersey Health, and sign a consent order agreeing to lifetime disbarment from participation as a provider in the New Jersey Medicaid program.
“Stealing from a program that provides financial assistance to those who cannot afford health insurance or health care services is not only a crime, it’s a disgrace,” Porrino said in a statement.
“This guilty plea ensures that the defendant will be held accountable for his actions and will never again be in a position to divert resources from those who truly need it.”
The Office of the Insurance Fraud Prosecutor also assisted in the investigation.
In pleading guilty, Valdes admitted that between January 2008 and March 2016, he fraudulently submitted claims totaling more than $100,000 to Horizon NJ Health, a provider of Medicaid services in the state.
The claims falsely stated that Valdes had distributed durable medical equipment including compression stockings, diapers and other items – to patients who, in fact, had died prior to the dates of the purported distributions.
Valdes is scheduled to be sentenced on January 5, 2018.
People who are concerned about insurance cheating and have information about a fraud can report it anonymously by calling the toll-free hotline at 1-877-55-FRAUD, or visiting their website at www.NJInsurancefraud.org.
State regulations permit a reward to be paid to an eligible person who provides information that leads to an arrest, prosecution and conviction for insurance fraud.