TRENTON
- Division of Criminal Justice Director
Vaughn L. McKoy announced that the Division
of Criminal Justice - Office
of Insurance Fraud Prosecutor has
charged a Camden County Probation Officer
and his former girlfriend with swindling
the New Jersey State Health Benefits Plan
(SHBP) out of more than $41,800 by misrepresenting
their marital status. The New Jersey State
Health Benefits Plan is administered by
Blue Cross/Blue Shield of New Jersey,
Aetna/USHealthcare, Protective Dental
Care (OraCare), and the New Jersey Division
of Pensions and Benefits.
According to Insurance Fraud Prosecutor
Greta Gooden-Brown, Lionel Maldonado,
41, N. Delsea Drive, Clayton, Gloucester
County, and his former girlfriend, Marisol
Perez, 33, Roosevelt Avenue, Glassboro,
Gloucester County, were charged via a
State Grand Jury indictment with theft
by deception (3rd degree) and falsifying
records (4th degree). If convicted of
both crimes, each defendant faces up to
six and a half years in state prison and
a fine of up to $25,000. The defendants
will be ordered to appear in Gloucester
County Superior Court for bail and arraignment
on a date to be determined by the Court.
The indictment alleges that between 1990
and 2000, Maldonado and Perez bilked the
SHBP out of more than $41,899. It is charged
that in March, 1990, Maldonado while employed
as a Public Health Investigator by the
Camden County Department of Health, falsified
the group enrollment application and fraudulently
enrolled Marisol Perez as his “wife”
on his SHBP. As a dependant wife, Marisol
“Maldonado” would have been
entitled to health care benefits provided
to Lionel Maldonado. An investigation
by the Office of Insurance Fraud Prosecutor
determined that Maldonado and Perez were
never legally married and, consequently,
Marisol Perez was not entitled to insurance
coverage as Maldonado’s purported
spouse.
It is charged that Maldonado and Perez
continued to fraudulently use the benefits
provided by the SHBP when Maldonado was
appointed a Camden County Probation Officer
in 1992. It is alleged that Maldonado
continued to identify Perez as his wife
when he enrolled her in family coverage
as part of the Prescription Drug Plan
- the prescription coverage provided to
State and County employees. Maldonado
and Perez continued to perpetuate the
fraud against the state and county health
and prescription benefits plans until
approximately July 1, 2000, when Maldonado
deleted Perez from all insurance coverage
on the grounds that they had separated.
In September of 2001, Maldonado reported
that he was widowed.
State Investigator Carlos Ortiz and Deputy
Attorney General Tanya Y. Justice were
assigned to the investigation. DAG Justice
represented the Division of Criminal Justice
- Office of Insurance Fraud Prosecutor
before the State Grand Jury. The New Jersey
Division of Pensions and Benefits assisted
in the investigation.
"Submitting
false health insurance claims is a serious
offence,” Fraud Prosecutor Gooden-Brown
said. “This crime is particularly
disturbing because it was committed against
the New Jersey State Health Benefits Plan
and thereby represents a theft of tax
dollars."
The indictment, handed up to Mercer County
Superior Court Judge Linda R. Feinberg,
Assignment Judge in charge of the State
Grand Jury on June 6, is merely an accusation.
The defendants are presumed innocent unless
and until proven guilty beyond a reasonable
doubt.
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