West New York business owner gets four years in prison for $101k Medicaid scam

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A West New York business owner has been sentenced to four years in state prison after admitting to a $101,000 Medicaid scam, Attorney General Gurbir Grewal announced. 

T-N-T Medical Supplies used to be located at 4911 Bergenline Avenue in West New York. Google Maps/Marc Gonzalez. Alfredo Valdes, Jr. photo courtesy of the NJ Attorney General's Office.
T-N-T Medical Supplies used to be located at 4911 Bergenline Avenue in West New York. Google Maps/Marc Gonzalez. Alfredo Valdes, Jr. photo courtesy of the NJ Attorney General’s Office.

By John Heinis/Hudson County View

Alfredo Valdes, Jr., 43, of Clifton, N.J., who owns T-N-T medical supplies in West New York, was sentenced on Friday to four years in state prison by Superior Court Judge Nesle A. Rodriguez in Hudson County, Grewal said in a statement.

Valdes pleaded guilty in August to second-degree charges of health care claims fraud and theft by deception.

He was ordered to pay $101,000 in restitution to Horizon New Jersey Health, and he signed a consent order agreeing to lifetime disbarment from participation as a provider in the New Jersey Medicaid program.

“Valdes systematically stole from Medicaid, billing the program more than $100,000 for medical supplies for patients who were deceased,” Grewal said in a statement.

“This prison sentence reflects the egregious nature of his conduct, as well as our resolve to fight Medicaid fraud and preserve program funding for our residents who otherwise could not afford health care.”

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.

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 the Web site 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.