On April 20, a New Jersey woman pleaded guilty to several criminal counts related to an alleged health care fraud scheme. The 61-year-old Springfield resident, who owns a home health care agency, admitted that she was involved in a scheme to defraud Medicaid. According to prosecutors, the scheme resulted in $7 million in losses for Medicaid.
At her court appearance, the accused woman admitted that she had sent fraudulent documents to state nursing officials. The documents reportedly stated that the home health aides the woman was interested in hiring had completed the required training and passed the required tests in order to receive their certifications. In reality, the woman had collected hundreds of dollars from each of the job candidates in exchange for her efforts to secure certifications for them using fraud.
Prosecutors have also charged the woman for billing Medicaid for services that patients did not actually receive. The accused woman allegedly bribed a state Labor Department employee who was working with a federal agent. If she is convicted of the charges for conspiracy, money laundering, bribery and tax evasion, the woman could receive a lengthy prison sentence.
A person who is facing charges for participating in a fraudulent health care scheme may want to be represented by a criminal defense attorney during interrogations by law enforcement officials to ensure that no incriminating statements are made that could subsequently be used by the prosecution at trial. An attorney will also likely conduct an examination of the process pursuant to which evidence has been obtained by the prosecution in order to see if any of the defendant's rights have been violated.
Source: My9NJ.com, "Home health agency owner admits to $7 million fraud scheme," April 21, 2015