Two Middletown Residents Accused of Medicaid Fraud
The defendants worked for NJ Mobile, which had a Colts Neck branch.
The Office of the Insurance Fraud Prosecutor obtained a 31-count state grand jury indictment on Feb. 7 charging seven defendants – including the owner a now-defunct Central Jersey mobile dental practice - for their alleged roles in a scheme to defraud the Medicaid program of over $5.5 million.
According to a news release distributed by the office of Attorney General Jeffrey S. Chiesa, the following defendants were variously charged with conspiracy, insurance fraud, health care claims fraud, theft by deception and one count of misconduct by a corporate official (all in the second degree) in addition to third-degree Medicaid fraud for their roles in the alleged scheme:
· Steven Beukas, 47, of Mahwah, Dentist and owner of New Jersey Mobile Dental Practice, P.A. (NJ Mobile);
· Illuminata “Lena” Davi, 56, of Lincroft, Office Manager at NJ Mobile
· Joyce Fuller, 56, of Lincroft, Medicaid Billing Manager at NJ Mobile
· Mary D. “Marydee” Anerousis, 47, of Livingston, Dentist at NJ Mobile
· John Freiler, 74, of Wanaque, Dentist at NJ Mobile
· Matthew Girardy, 42, of Spring Lake, Dentist at NJ Mobile
· Trina Ruchelman, 40, of Cream Ridge, Dentist at NJ Mobile
“These defendants’ alleged actions not only defrauded the Medicaid program, but also preyed upon vulnerable individuals who sought to utilize NJ Mobile’s services,” Attorney General Chiesa said.
“With this indictment, the Office of the Insurance Fraud Prosecutor continues to aggressively prosecute those in the health care profession that seek to take advantage of those for whom they are tasked with caring,” Acting Insurance Fraud Prosecutor Ronald Chillemi said.
NJ Mobile, which had a business office in Colts Neck, was comprised of a group of dentists that traveled to various nursing homes, assisted living facilities, adult day care facilities, and private homes throughout New Jersey in order to provide on-site dental treatment.
The indictment alleges that between Jan. 1, 2003 and Aug. 1, 2009, Beukas, Davi and Fuller stole $5,548,822 from Medicaid by creating the false impression that Anerousis, Freiler, Girardy and Ruchelman, as well as other mobile dentists, were entitled to reimbursement for dental services that they purportedly provided. In some instances, the defendants allegedly overbilled Medicaid for services that were provided through the mobile dental practice. It is alleged that NJ Mobile systematically added a charge for Behavior Management on almost every Medicaid patient purportedly treated regardless of whether the dentists actually spent the additional time with the patient that would warrant that charge.
In other instances, the dentists allegedly billed Medicaid for dental procedures that were not provided. For example, the indictment alleges that Beukas and Anerousis caused 3,714 claims to be fraudulently submitted to Medicaid for reimbursement for a dental procedure that was never actually provided. In one case, Freiler allegedly submitted claims for reimbursement for a purported Medicaid recipient. An investigation determined that the Medicaid recipient was deceased at the time that Freiler purportedly provided the dental service.
It is also alleged that the defendants would systematically add a “trip charge” to almost every Medicaid patient in the facility despite the fact that the dentists were only entitled to one per trip to the facility, regardless of the number of patients examined or treated. It is alleged that the dentists would then subsequently retain the payments from Medicaid to which they were not entitled.
The investigation began when the Medicaid Fraud Control Unit uncovered NJ Mobile’s suspicious billing for Medicaid patients.
As a result of the investigation, which included undercover surveillance and an execution of a search warrant at NJ Mobile’s Colts Neck office, six mobile dentists previously pleaded guilty to criminal accusations.
Deputy Attorney General Oriana Nadraga, Sgt. Kathleen Casey, and Auditor Kim Geis, coordinated the investigation. Additional assistance was provided by Sgt Joseph Jaruszewski,
Detective Anthony Correll, Management Assistant Mitzi Gross, Attorney Assistant Mona Patel and Technical Assistant B'leia Williams
The indictment is merely an accusation and the defendants are presumed innocent until proven guilty.
Second-degree crimes carry a maximum sentence of 10 years in state prison and a criminal fine of up to $150,000 while third-degree crimes carry a maximum sentence of five years in state prison and a criminal fine of up to $10,000.