TRENTON – Acting Attorney General John Hoffman and the Office of the Insurance Fraud Prosecutor (OIFP) announced that a Monmouth County woman received a three-year state prison term for submitting fraudulent healthcare claims that totaled more than $500,000 to her insurer over a two-year span.
Donna Dzienisewski, 41, of Middletown, was sentenced by Monmouth County Superior Court Judge Anthony J. Mellaci Jr. She pleaded guilty in October to second-degree health care claims fraud.
Dzienisewski admitted that between March 18, 2011 and March 12, 2013, she submitted 107 claims to Horizon Blue Cross Blue Shield of New Jersey that gave the false impression that she incurred approximately $502,740 in total reimbursable expenses for health care services. Dzienisewski never actually visited the doctor on 101 of those occasions and incurred no medical expenses at all on those occasions. She incurred only approximately $2,640 in medical expenses for the remaining six claims, even though she altered the six medical invoices corresponding to these claims to show falsely that she incurred a total of $8,640 in medical expenses. In total, Dzienisewski deposited $141,126 into her bank account as a result of her fraudulent activity.
“More than 100 times, Dzienisewski lied to her insurer so that she could enrich herself with well over $100,000 over a two-year span,” said Acting Attorney General Hoffman. “The egregious and dishonest nature of her crime has rightfully led to a prison term.”
“Defrauding an insurance company is not the path to easy money, it is the road to prison,” said Acting Insurance Fraud Prosecutor Ronald Chillemi. “We will continue to vigorously prosecute these cases and seek punishment for those who commit these crimes.”
Deputy Attorney General Bradford Muller represented the state at the sentencing hearing. Deputy Attorney General T.J. Harker and Detectives Wendy Berg and Matthew Armstrong coordinated the investigation. Analyst Kelly Celenza provided substantial assistance in the financial analysis of the investigation. Acting Insurance Fraud Prosecutor Chillemi thanked Horizon Blue Cross Blue Shield of New Jersey for referring the matter.
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.