TRENTON
- Division of Criminal Justice Director
Vaughn L. McKoy announced that an Essex
County man has pleaded guilty to fraudulently
misrepresenting that he and his family
were qualified for Medicaid benefits.
According to Insurance Fraud Prosecutor
Greta Gooden-Brown, Anthony Murphy, 49,
of Kenz Terrace, West Orange, Essex County,
pleaded guilty before Essex County Superior
Court Judge Michael Ravin to a criminal
Accusation filed by the Division of Criminal
Justice. The Accusation charged Murphy
with Medicaid Fraud, and failure to pay
income taxes, (both 3rd degree). When
sentenced on Sept. 9, Murphy faces up
to eight years in state prison and a fine
of up to $25,000.
At the June 29 guilty plea hearing, Murphy
admitted that between May 30, 2001 and
March 30, 2004, he wrongfully obtained
health benefits from the Medicaid Program.
Murphy admitted that he applied for FamilyCare
for himself, his wife, and his three children
by falsely advising the Division of Medicaid
Assistance and Health Services that he
did not have health insurance through
his employment and could otherwise not
afford health coverage. An investigation
by the Division of Criminal Justice -
Office of Insurance Fraud Prosecutor determined
that Murphy falsely advised Medicaid that
his income level qualified him to enroll
in the FamilyCare program sponsored by
Medicaid.
The Medicaid Program, which is funded
by the state and federal governments,
provides health care services and prescription
drugs to persons who may not otherwise
be able to afford such services and medicines.
The State of New Jersey administers the
Medicaid Program through the Division
of Medical Assistance and Health Services
and, through the Office of the Insurance
Fraud Prosecutor’s Medicaid Fraud
Section, which investigates both criminal
and civil Medicaid fraud and abuse in
that program.
Murphy
further admitted that he is a self-employed
contractor and the owner of A. Murphy
Contracting. The investigation further
determined that the income and profits
Murphy received from that business far
exceeded the $25,071 per year income limit
necessary to qualify for FamilyCare.
State Investigators Michael English and
Michael Behar and Deputy Attorney General
Mark J. Ondris coordinated the investigation.
DAG Ondris represented the Division of
Criminal Justice - Office of Insurance
Fraud Prosecutor at the guilty plea hearing.
Mark Philips, Auditor with the State Division
of Taxation, assisted in the investigation.
“While
the Medicaid Fraud Section of the Office
of the Insurance Fraud Prosecutor most
often investigates and prosecutes Medicaid
claim fraud, this case represents a prosecution
where a person lied to obtain Medicaid
health coverage,” Fraud Prosecutor
Greta Gooden-Brown said. “This office
will investigate allegations of persons
lying about their eligibility for Medicaid
coverage and will prosecute such persons
in order maintain integrity within the
Medicaid Program.”
Noting that some important cases have
begun with anonymous tips from the public,
Prosecutor Gooden-Brown emphasized that
individuals can make a difference. “We
need people’s information, not their
identities. People who are concerned about
insurance cheating and have any information
about a fraud can call our toll-free hotline
at 1-877-55-FRAUD, or visit our Web site
at www.NJInsurancefraud.org
.”