TRENTON –Attorney General Gurbir S. Grewal and the Office of the Insurance Fraud Prosecutor (OIFP) announced that the owner of a Hudson County medical equipment supply store was sentenced today to prison for fraudulently billing the Medicaid program more than $100,000 for medical supplies never provided to patients.
Alfredo Valdes, Jr., 43, of Clifton, N.J., who owns T-N-T medical supplies in West New York, was sentenced today to four years in state prison by Superior Court Judge Nesle A. Rodriguez in Hudson County. Valdes pleaded guilty in August to second-degree charges of health care claims fraud and theft by deception. Valdes was ordered to pay $101,000 in restitution to Horizon New Jersey Health, and he signed a consent order agreeing to lifetime disbarment from participation as a provider in the New Jersey Medicaid program.
“Valdes systematically stole from Medicaid, billing the program more than $100,000 for medical supplies for patients who were deceased,” said Attorney General Grewal. “This prison sentence reflects the egregious nature of his conduct, as well as our resolve to fight Medicaid fraud and preserve program funding for our residents who otherwise could not afford health care.”
“Every dollar lost to Medicaid fraud is one less dollar available to help some of the most vulnerable citizens of our state,” said Acting Insurance Fraud Prosecutor Christopher Iu. “Our Medicaid Fraud Control Unit will continue to aggressively investigate and punish those who exploit the Medicaid system for their personal enrichment.”
In pleading guilty, Valdes admitted that between January 2008 and March 2016 he fraudulently submitted claims totaling more than $100,000 to Horizon NJ Health, a provider of Medicaid services in the state. The claims falsely stated that Valdes had distributed durable medical equipment – including compression stockings, diapers and other items – to patients who, in fact, had died prior to the dates of the purported distributions.
Deputy Attorney General Melissa Simsen represented the State in the plea hearing. Detectives Anthony Iannice and Kylie Mattis coordinated the investigation with assistance from the Special Investigation Unit at Horizon New Jersey Health, and Analysts Keira McRae-Wiggins and Kelly Celenza. Acting Insurance Fraud Prosecutor Iu thanked the SIU Unit at Horizon for referring the matter to the Office of the Insurance Fraud Prosecutor.
Acting Insurance Fraud Prosecutor Iu 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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