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Admits to taking part in theft of $49,941
The medical director of a defunct Mercer County mental health clinic was sentenced Monday to three years in state prison for his role in a conspiracy to fraudulently over-bill the Medicaid and Medicare programs of $49,941.
Arnold Jacques, 61, of Jackson, the former medical director of the Chambers Mental Health Clinic, a mental health counseling center in Trenton, was ordered to repay the money to the Medicaid and Medicare programs by state Superior Court Judge Edward M. Neafsey in Trenton, state Acting Insurance Fraud Prosecutor Riza Dagli said.
Jacques' sentence was based on his Sept. 8 guilty plea to second-degree conspiracy, second-degree health care claims fraud, and third-degree Medicaid fraud. The charges were contained in a state grand jury indictment returned in 2007.
In pleading guilty, Jacques, a medical doctor who practices as a psychiatrist, admitted that between January 2004 and November 2005, he conspired with the two co-owners of the clinic to fraudulently over-bill the Medicaid and Medicare programs.
Jacques and his co-defendants, Pedro Acosta, 65, of Queens, and Osvaldo Morales Sr., 62, of the Bronx, caused Medicaid and Medicare claims to be billed under Jacques' Medicaid and Medicare provider numbers even though he did not personally provide the counseling services billed.In addition, among other things, the trio billed Medicaid and Medicare for longer counseling sessions than those that were actually provided, billed for family counseling in addition to individual sessions for the same patient in the same day, and billed for counseling services that were not rendered at all.
Medicaid pays a higher rate for longer counseling sessions and for counseling services provided by a specialist medical doctor as opposed to counselors with lesser licenses. Jacques, Acosta, and Morales thereby fraudulently billed the Medicaid and Medicare programs for the $49,941 to which they were not entitled.
Acosta and Morales previously pleaded guilty. Acosta pleaded guilty to second-degree health care claims fraud and Morales pleaded guilty to third-degree Medicaid fraud. They are awaiting sentencing.
Detectives Joseph Jaruszewski and Kevin Gannon and former Deputy Attorney General Sherry L. Wilson handled the investigation. Deputy Attorney General Erik Daab is prosecuting the case.
– TOM HESTER SR., NEWJERSEYNEWSROOM.COM
