According to Insurance Fraud Prosecutor Greta Gooden Brown, Dr. Roger H. Brown, 49, Old Dutch Road, Warren, Warren County, was sentenced by Somerset County Superior Court Judge Paul W. Armstrong to three years in state prison and ordered to pay a $25,000 criminal penalty. Brown previously paid $310,546 in restitution and civil fines to the Medicaid Program and private insurance companies.

Insurance Fraud Prosecutor Gooden Brown said that Dr. Brown, a licensed dentist and the owner of Amwell Dental Associates located at 601 Route 206, Hillsborough, Somerset County, pleaded guilty before Judge Armstrong on May 27 to a criminal Accusation that charged Health Care Claims Fraud. In pleading guilty, Brown admitted that between January, 1993 and September, 2004, to submitting hundreds of false claims for reimbursement of dental services purportedly provided to patients to various medical providers, including the Medicaid Program, Delta Dental, MetLife, Horizon Blue Cross/Blue Shield, CIGNA Insurance, and Aetna Insurance companies. The investigation revealed that $95,182 in false claims were submitted to the medical service providers - $59,970 in false claims sent to the Medicaid Program and $35,213 billed to private insurance companies. The false claims represented bills for dental services that were not provided to patients. In other cases, Brown admitted that he misrepresented the dates on which services were rendered and fraudulently billed for providing Temporomandibular Joint Dysfunction (TMJ) Nightguards when providing cosmetic dental services not covered by private dental insurance.

The investigation was conducted by the Division of Criminal Justice - Office of the Insurance Fraud Prosecutor, Medicaid Fraud Control Unit, which investigates and prosecutes civil and criminal Medicaid fraud cases. State Investigators Robert McGrath and Michael Rasar, and Deputy Attorneys General Marquis D. Jones, Jr. and Alvina Seto were assigned to the investigation. DAG Jones represented the Division of Criminal Justice - Office of the Insurance Fraud Prosecutor at the sentencing.

“Medicaid fraud schemes involve the theft of tax dollars and represent a theft from a program designed to assist persons who can not afford health insurance or health care services. Such cases are a priority for the Office of the Insurance Fraud Prosecutor,” said Insurance Fraud Prosecutor Brown.

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