Monday, February 20, 2012

New Jersey dentist indicted for Medicaid fraud


An announcement from the Office of the New Jersey Attorney General:
Attorney General Jeffrey S. Chiesa announced that a Monmouth County dentist has been indicted for allegedly submitting false claims to the Medicaid program.  Ping Cai, 49, of Holmdel, a licensed dentist whose practice is located in Hazlet, was charged with second-degree health care claims fraud and two counts of third-degree Medicaid fraud.

The Monmouth County grand jury indictment alleges that between Jan.1, 2007 and Jan.1, 2010, Cai fraudulently billed the Medicaid Program for dental service purportedly rendered to Medicaid recipients.  It is alleged that Cai submitted fraudulent claims for payment from Medicaid for relining and rebasing of dentures and filling of cavities when those dental services were not rendered. 

An investigation by the Office of the Insurance Fraud Prosecutor’s Medicaid Fraud Control Unit determined that, as a result of alleged fraud, Cai was allegedly paid more than $39,000 by Medicaid for the services that were not rendered. Deputy Attorney General Linda A. Rinaldi and Detective Ralph Anilo were assigned to the investigation. Rinaldi presented the case to the Monmouth County grand jury.    

The indictment, which was voted on Jan. 23 but handed up yesterday, is merely an accusation and the defendant is presumed innocent until proven guilty. Second-degree crimes carry a maximum sentence of 10 years in state prison and a criminal fine of $150,000, while the crime of third-degree Medicaid Fraud carries a maximum sentence of three years in state prison and a criminal fine of $10,000. 

Acting Insurance Fraud Prosecutor Ronald Chillemi thanked Medicaid for referring the matter to the Office of the Insurance Fraud Prosecutor. Acting Insurance Fraud Prosecutor Chillemi noted that some important cases have started with anonymous tips.  “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.

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