What Constitutes Insurance Fraud?

Insurance fraud occurs when individuals or organizations intentionally deceive an insurance provider for financial gain. The misconduct can be classified into two primary categories: hard fraud and soft fraud.

Hard fraud involves deliberate actions such as fabricating an accident, falsifying a theft, or creating fake medical bills.

Soft fraud is more subtle and often includes exaggerating damages, misrepresenting facts on applications, or inflating repair costs.

Fraudulent claims may arise in various types of coverage, including auto, health, workers’ compensation, property, and life insurance. Regardless of the category, such schemes have far-reaching consequences, straining resources and leading to increased costs for legitimate policyholders.

Agencies Responsible for Investigations

New Jersey has dedicated authorities that focus on uncovering and prosecuting fraudulent insurance activities. These entities work together to identify suspicious claims and enforce penalties against offenders.

Office of the Insurance Fraud Prosecutor (OIFP)

A division within the New Jersey Attorney General’s Office, the OIFP is responsible for investigating and prosecuting fraudulent insurance activities. This office collaborates with law enforcement agencies and insurance companies to detect violations and take legal action against perpetrators.

New Jersey Department of Banking and Insurance (NJDOBI)

The NJDOBI oversees the regulation of insurance carriers operating within the state. It ensures compliance with laws and addresses concerns related to fraud by working alongside insurers and government agencies.

National Insurance Crime Bureau (NICB)

A nonprofit organization, the NICB partners with insurers and law enforcement to analyze patterns of suspicious claims. This entity plays a crucial role in detecting widespread schemes and providing intelligence to investigators.

Local Law Enforcement and Prosecutors

Depending on the severity of the case, municipal police departments and county prosecutors may handle fraud investigations. Complex schemes often involve multiple jurisdictions, requiring cooperation between local and state authorities.

Consequences of Insurance Fraud

New Jersey imposes strict penalties on individuals found guilty of committing insurance fraud. Offenders may face criminal charges, leading to fines, restitution, or even imprisonment. Additionally, civil lawsuits can result in further financial liabilities. Beyond legal repercussions, those caught engaging in deceitful practices may suffer reputational damage and find it difficult to secure future coverage.

How to Report Suspected Fraud

Anyone who suspects fraudulent activity can report their concerns through various channels:

New Jersey Insurance Fraud Hotline – The OIFP maintains a confidential tip line for individuals to report suspicious claims.

Insurance Companies – Most providers have dedicated fraud prevention units that investigate questionable activities.

Local Authorities – Individuals can file reports with law enforcement if they witness fraudulent behavior.

Final Thoughts

Insurance fraud is a significant concern in New Jersey, affecting both businesses and consumers. With strict enforcement mechanisms in place, authorities remain vigilant in combating deceptive practices. By staying informed and reporting suspicious activities, residents can help mitigate fraud’s impact and contribute to a more secure and fair insurance system.

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Here’s what you need to know about mortgage fraud charges in the state.

What is Mortgage Fraud?

Mortgage fraud occurs when false information is intentionally provided during the mortgage application process or in the course of a real estate transaction to obtain a loan, property, or better terms than would otherwise be available. Mortgage fraud can take many forms, including:

Income misrepresentation: Falsifying income, employment, or tax documents to secure a loan or obtain better rates.

Property value inflation: Misstating the value of a property to deceive lenders into approving a higher loan amount.

Occupancy fraud: Claiming a home will be used as a primary residence to receive better loan terms when the property is intended as a rental or investment.

Straw buyer schemes: Using someone else’s credit or identity to secure a mortgage on a property, often for financial gain.

Foreclosure rescue scams: Misleading homeowners into transferring ownership of their homes under the false pretense of avoiding foreclosure.

Mortgage fraud can be committed by borrowers, real estate professionals, mortgage brokers, or anyone involved in a real estate transaction. It can also be prosecuted at the state or federal level, depending on the scope and complexity of the fraud.

Penalties for Mortgage Fraud in New Jersey

The penalties for mortgage fraud in New Jersey depend on the nature and scale of the offense. In many cases, mortgage fraud is charged as a form of theft or financial crime. Mortgage fraud can be categorized as either a misdemeanor or felony, with more severe cases leading to felony charges.

Key penalties for mortgage fraud can include:

Prison sentences: Defendants convicted of mortgage fraud could face substantial prison time, especially in cases involving large sums of money or multiple victims. Sentences can range from several years to over a decade, depending on the severity of the case.

Fines: Financial penalties for mortgage fraud can be steep, with fines reaching tens of thousands of dollars or more in significant cases.

Restitution: Courts may order the defendant to pay restitution to victims, compensating lenders or other affected parties for their financial losses.

Probation: In less severe cases or for first-time offenders, courts may impose probation instead of jail time, requiring the accused to adhere to specific conditions, such as community service or regular check-ins with a probation officer.

Damage to reputation and career: Beyond legal penalties, being convicted of mortgage fraud can severely harm your personal and professional life. Real estate professionals, mortgage brokers, or financial industry workers may lose licenses, jobs, or their ability to work in their chosen fields.

Building a Defense Against Mortgage Fraud Charges

If you are facing mortgage fraud charges in New Jersey, mounting a strong defense is essential. Some common defense strategies include:

Lack of Intent: Mortgage fraud charges require the prosecution to prove that you intentionally provided false information or committed fraud. If your actions were the result of a mistake, oversight, or misunderstanding, it may be possible to argue that you lacked the intent necessary to commit fraud.

Insufficient Evidence: Prosecutors must provide clear evidence that fraud occurred and that you were involved. If the evidence is weak, circumstantial, or based on assumptions, a skilled NJ attorney may be able to challenge the prosecution’s case and create reasonable doubt.

Duress or Coercion: If you were forced or manipulated into participating in fraudulent activity, such as in a straw buyer scheme, your attorney may argue that you acted under duress or coercion and were not voluntarily involved in the fraud.

Mistake of Fact: Sometimes, false information is provided during the mortgage process without knowledge that it is incorrect. A common defense is to show that any errors made were unintentional and based on inaccurate information provided by a third party.

Challenging Evidence Collection: If law enforcement obtained evidence through illegal means, such as an unlawful search or seizure, your attorney may file a motion to suppress that evidence, which could weaken the prosecution’s case or lead to a dismissal of charges.

The Importance of Legal Representation

Mortgage fraud cases are complex and require thorough legal expertise to navigate successfully. If you are accused of mortgage fraud in New Jersey, working with an experienced criminal defense attorney is critical. Your attorney can help you understand the charges against you, gather evidence, and develop a strong defense strategy tailored to your case.

An experienced lawyer will also negotiate with prosecutors to seek reduced charges, dismissals, or plea bargains when possible, helping to minimize the impact of the allegations on your life.

Facing mortgage fraud charges in New Jersey is a serious matter that can carry long-lasting consequences. If you are accused, taking prompt legal action is key to protecting your rights, reputation, and future. Seek out the guidance of a skilled New Jersey criminal defense attorney to ensure you are fully prepared to defend yourself and navigate the legal process ahead.

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Defining Credit Card Theft in New Jersey

In NJ, credit card theft is broadly defined as the unlawful taking of someone else’s credit card, debit card, or any other financial transaction device with the intent to use, sell, or transfer it for fraudulent purposes. This includes scenarios where an individual steals, receives, or possesses a credit card without the cardholder’s consent.

Penalties Based on the Value of Goods or Services Obtained

One key factor that influences the severity of penalties for credit card theft in New Jersey is the value of the goods or services obtained through the unauthorized use of the stolen card. The state classifies offenses into different degrees based on this value.

Third-Degree Offense

When the value of the goods or services obtained is less than $500, stealing a credit card is considered a third-degree offense. Penalties may include imprisonment for three to five years and fines of up to $15,000.

Second-Degree Offense

If the value exceeds $500, credit card theft is elevated to a second-degree offense. The penalties for a second-degree offense may include imprisonment for five to ten years and fines of up to $150,000.

Possession of Stolen Credit Cards

Beyond the actual use of stolen cards, simply possessing stolen credit cards can lead to criminal charges in New Jersey. The penalties for possession are also determined by the value of the goods or services the possessor intended to obtain.

Fourth-Degree Offense

Possession of fewer than five stolen credit cards with the intent to use them unlawfully is considered a fourth-degree offense. Penalties may include imprisonment for up to 18 months and fines of up to $10,000.

Third-Degree Offense

If the possessor intends to use more than five stolen credit cards, it becomes a third-degree offense. Penalties for a third-degree offense may include imprisonment for three to five years and fines of up to $15,000.

Additional Penalties and Legal Consequences

Apart from imprisonment and fines, individuals convicted of a theft in NJ may face additional legal consequences. These can include restitution to the victim, probation, and court-ordered counseling or community service.

Potential Defenses Against Credit Card Theft Charges

While the penalties for this type of crime are severe, individuals facing such charges may explore various legal defenses. Common defenses include lack of intent, mistaken identity, or insufficient evidence to prove guilt beyond a reasonable doubt. Consulting with a knowledgeable criminal defense attorney is crucial for building a robust defense tailored to the specific circumstances of the case.

Reporting Credit Card Theft and Seeking Legal Counsel

If you believe you are a victim of credit card fraud, it is crucial to report the incident to law enforcement and your card issuer promptly. On the other hand, if you are facing charges related to theft, seeking legal counsel is imperative. An experienced attorney can assess the details of your case, advise you on the best course of action, and advocate for your rights throughout the legal process.

Credit card theft in New Jersey is met with stringent penalties that escalate based on the value of goods or services obtained through the unauthorized use of stolen cards. Understanding the potential consequences and seeking legal guidance when facing such charges is essential for individuals navigating the complex legal landscape surrounding this charge in the state.

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Computer fraud is any act of fraud that is committed with the use of a computer or the internet. Fraud is the intentional deception of another person or group of people for one’s personal, usually financial, gain. The term “computer theft” is also used to refer to computer-based crimes. Various tools can and have been used to commit fraud throughout history. Since becoming widespread in the 1980s, personal computers have become increasingly popular tool for thieves. As computer technology advances, the laws governing computer use as criminal tools evolve. This fairly young branch of criminal law draws precedents from notable cases from the 1990s and 2000s, such as the Melissa virus, which originated in New Jersey and eventually caused more than $400 million in damage from clogged email systems and impaired internet service to businesses in the United States.

N.J.S.A. 2C:20-25 defines the actions that constitute computer fraud in New Jersey. The following, when committed with the intention of gaining financially or otherwise at another person or group of people’s expense, are the types of computer fraud recognized by New Jersey.

If the defendant accesses any computer network, data storage system, software, computer system, network of systems or the data stored within without or in excess of authorization, he or she may be charged with a third degree crime.

It is a second degree crime to alter, damage, or destroy any of the aforementioned computer-related property.

It is a second degree crime to deny or disrupt any type of computer or internet service to others.

Using any of the previously mentioned computer systems or components to obtain personal information, services, money or property is a third degree crime unless the value of the property stolen is greater than $5,000, in which case, it is a second degree crime.

Taking, copying, or using any data, software, database, computer system, personal information, information stored in a computer network, system or storage device or program is a third degree crime unless any of the following criteria are met. In these cases, it is a second degree crime.

1. If the data, datastorage device or system stolen contains personally identifyinginformation, personal record of medical conditions, diagnoses, ormedical treatment for an identifiable individual.
2. If the data stolencontains sensitive government or otherwise court-protected records.
3. If the value ofthe data or system stolen is greater than $5,000.

Accessing simply to recklessly damage, destroy or compromise data, a program, a computer system, network or storage medium, database or any type of software is a fourth degree crime. If the monetary value of the property damaged is higher than $5,000, it is elevated to a third degree crime.

Any of the above crimes may become first degree charges if any of the following circumstances are met:

• The monetary valueof the victim’s loss is greater than $250,000.
• A victim sufferssignificant injury as a result of the crime.
• A public servicesuffers a major outage as a result of the crime. Public servicesinclude internet service, gas, electricity and water service, andpublic transportation. A major outage is any loss of service thatresults in a risk of significant bodily harm or death for any personor people, lasts anywhere from two to four hours, and causes atleast ten structures a loss of service.

If the victim of a computer-related crime is younger than eighteen years old, the charges against the defendant may be raised to “aggravated” status, which carries more strenuous penalties than non-aggravated offenses.

Many computer crimes are committed through the use of viruses. Developers create viruses that can be shared through email, shareware or websites that embed themselves into recipient computers and can steal personal information, such as passwords for online accounts. The best way to protect one’s computer from this type of crime is to have an updated anti-malware program installed and never open files from an unknown sender.

If you have been involved in a computer-related fraud case, call Ron Bar-Nadav at 201-525-1555 to discuss your legal options. His years of experience in New Jersey criminal law will help you build a solid foundation for your case. Don’t delay – call now to discuss your case’s details and find out the best way to pursue it in court.

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Consumer fraud is defined in N.J.S.A. 56:8-2 as “any unconscionable commercial practice, deception, fraud, false promise, or misrepresentation” committed by a salesperson while promoting the sale of any material goods, services, or real estate properties. Consumer fraud can be committed during transactions that aren’t strictly sales as well – property rentals and the distribution of goods are also subject to consumer fraud laws.

There are three ways consumer fraud can be committed:
1. Affirmative Misrepresentation.
This is an untrue statement used to make a sale. Whether the defendant knew his or her statement was true or false is irrelevant to his or her defense. Note how this act differs from the traditional definition of fraud: the defendant does now have to have intentionally misled his or her victim or victims for the action to be considered consumer fraud. If any false statement was used in an attempt to sell a piece of property, a service, or an item, the defendant may be charged with consumer fraud through affirmative misrepresentation.

2. Knowing Omission
This is lying by omission. If the defendant knowingly concealed, omitted, or suppressed any important information about the good, service or property he or she was offering for sale before or during its transaction, he or she is guilty of consumer fraud through knowing omission.

3. Violation of Certain Laws
This is when the seller breaks any other existing New Jersey laws regarding the transaction of goods, services or real estate when attempting to make a sale. An example of this would be promoting a specific food as vegan, even though it contains non-vegan ingredients. There are many specific laws written about sales in New Jersey.

The victim must prove that he or she suffered a quantifiable loss as a result of consumer fraud to be able to file a claim. Any person convicted of consumer fraud must pay back three times the amount of money his or her victim lost in damages. This is called restitution. Restitution exists to help victims of theft and fraud recover money they lost as a result of the crime. N.J.S.A. 2C:44-2(b) discusses restitution in New Jersey, such as how the court may set up a payment plan for a guilty defendant and how the amount of money he or she must pay is decided.

Consumer fraud may be committed in any medium through which sales are made. This means through word of mouth, in-store promotions, and through sales websites such as ebay.com and craigslist.org. For more detailed information about computer-related fraud laws in New Jersey, see our page about computer fraud. As computers become more and more integrated into our everyday lives, computer-based crimes become more prevalent.

The New Jersey Division of Consumer Affairs is a government office that works to enforce consumer fraud laws in New Jersey. Its jurisdiction includes lemon law enforcement, automobile leasing laws in New Jersey, Halal and Kosher food regulation, cyberfraud, warehousing, charities, home improvement contractors, identity theft prevention and enforcement of the Do Not Call list for telemarketers. It also exists to resolve disputes within the realm of consumer law, oversees legal gambling within New Jersey, ensures that commercial weight and measurement devices operated by the state are correctly calibrated and maintained, and supervises many boards and committees that in turn govern the businesses that operate within New Jersey. These boards and committees play a large role in licensing more than half a million New Jersey workers.

If you have been accused of consumer fraud and want to start building a strong defense, call Ron Bar-Nadav at 201-525-1555. His years of experience in criminal law will be one of your greatest assets when it comes time to collaborate on your defense.

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Louisiana Woman Sentenced for Health Care Fraud
On September 5, 2013, in Baton Rouge, La., Sonya Lewis Williams was sentenced to 37 months in prison for health care fraud and money laundering. Williams was also ordered to pay $1,223,471 in restitution to the Department of Health and Human Services/Centers for Medicare and Medicaid Services. According to court documents, Williams operated two companies known as Fusion Services, LLC (Fusion) and Grace Social Services, LLC (Grace). Williams established the two companies for the purpose of using unlicensed social workers to visit Medicare beneficiaries in their homes several times a week to perform case management, counseling, and social interaction services. Williams submitted false claims for reimbursement from Medicare indicating that the beneficiaries had received individual, face-to-face psychotherapy from a licensed clinical social worker when no such services had been provided. Medicare paid Fusion and Grace approximately $349,715 as a result of the billings. Much of the profits were transferred from company bank accounts into Williams’ personal accounts.

West Virginia Chiropractor Sentenced on Health Care Fraud and Tax Evasion Charges
On September 5, 2013, in Wheeling, W.Va., Joseph J. Yurigan, of New Alexandria, Pa., was sentenced to 18 months in prison and two years of supervised release. Yurigan pleaded guilty on October 9, 2012, to one count of health care fraud by submitting a fraudulent claim to a health care benefit program and one count of income tax evasion for the calendar year 2008. Yurigan, a doctor of chiropractic medicine and licensed to practice in the State of West Virginia, operated two chiropractic clinics in West Virginia. As part of his plea agreement, Yurigan will make restitution of $513,373 for the health care violation and $322,692 for the tax evasion violation.

California Man Who Recruited ‘Patients’ Sentenced in Health Care Scam
On August 26, 2013, in Los Angeles, Calif., Estill Mitts was sentenced to 18 months in prison and ordered to pay more than $9.8 million in restitution. Mitts pleaded guilty in 2008 to conspiracy to commit health care fraud, money laundering and tax evasion. According to court documents, from 2004 until October 2007, Mitts operated the Assessment Center, a facility on East Seventh Street in downtown Los Angeles that was also known as 7th Street Christian Day Center. The Assessment Center was not a medical clinic, but a site Mitts used for the purpose of recruiting homeless Medicare and Medi-Cal beneficiaries for referral to three hospitals. Mitts and others working for him would recruit homeless beneficiaries for in-patient hospital admissions whether or not such hospitalizations were medically necessary. In addition, Mitts failed to report more than $479,000 in income in 2005 and more than $620,000 in income in 2006, resulting in a tax loss of $349,857.

Florida Chiropractor Sentenced for Fraudulent Insurance Scheme
On August 14, 2013, in Fort Myers, Fla., Dr. Stephen M. Lovell, of Windermere, was sentenced to 60 months in prison and ordered to pay $1.695 million money judgment. Lovell was convicted on February 28, 2013 on charges of conspiracy to commit health care fraud. According to trial evidence, Lovell was a licensed chiropractor and the purported co-owner of Xtreme Care Rehabilitation Center Inc. (Xtreme Care) in Cape Coral, Fla. Lovell and his co-conspirators recruited people to be involved in staged accidents and received injuries. These people would then go to Xtreme Care in exchange for payment. Xtreme Care then billed insurance companies by submitting false claims for alleged medically necessary treatments that these patients received. Treatment was either never provided to these patients or was not medically necessary. Upon payment by the insurance company, the funds were transferred to corporations created by the conspirators to launder the proceeds. Ultimately, Lovell and his co-conspirators received the benefits of the fraudulent activity through payments or expenditures for themselves from the corporate bank accounts.

Mental Health Counselor Sentenced for Defrauding Medicaid
On August 8, 2013, in Charlotte, N.C., Linda Smoot Radeker, of Shelby, N.C., was sentenced to 72 months in prison, two years of supervised release and ordered to pay $6,156,674 in restitution to Medicaid. In September 2012, Radeker pleaded guilty to one count of health care fraud conspiracy and two counts of money laundering. According to court documents, from 2008 to 2011 Radeker obtained at least $6.1 million in fraudulent reimbursement payments from false claims submitted to Medicaid. Radeker, a licensed professional counselor enrolled with North Carolina Medicaid, falsely claimed in billings submitted to Medicaid that she was the attending clinician for services provided to Medicaid recipients, when no such services were provided. In addition, Radeker “rented out” her Medicaid provider number to a network of co-conspirators and, in return, kept a percentage of the fraudulent Medicaid reimbursements, sometimes as much as 50%. On the fraudulent claims, the co-conspirators primarily used the Medicaid numbers of children whose parents thought were being enrolled in after school programs. These after school programs were, in fact, owned and operated by Radeker’s co-conspirators.

Two Women Sentenced for Medicaid Fraud
On July 24, 2013, in Reno, Nev., Cassandra Little, of Reno, was sentenced to 33 months in prison, three years of supervised release and ordered to pay $81,400 in restitution. Little pleaded guilty in March 2013 to 28 counts of health care fraud and 10 counts of money laundering. Susan Hill, of Las Vegas, was sentenced to 18 months in prison, three years of supervised release and ordered to pay $81,400 in restitution.Hill pleaded guilty in March 2013 to one count of health care fraud and one count of money laundering. According to the court records, from about January 2007 to January 2011, Hill and Little defrauded the Nevada Medicaid program of approximately $1 million by fraudulently billing for expensive therapy-related services which were never provided. To execute their scheme, Hill and Little formed a company, the Hill/Little LLC, and entered into a contract with Nevada Medicaid to provide health care services to children who were eligible for Medicaid. Little, a PhD and licensed social worker, was to provide the clinical services to the children. Hill and Little then created a program to obtain aid for the parents of the children who were eligible to receive the Medicaid funding; however, the program was not authorized or allowed under their Medicaid contract with the state. Hill recruited parents and guardians to provide services to their own children following minimal training provided by Hill/Little LLC. The services were nothing more than what parents normally do without reimbursement. Hill/Little LLC then billed Medicaid approximately $8,000 per month for each child, using a billing code which was only authorized for services that could have been provided by Little, the licensed social worker. Hill/Little kept $5,000 per month for each child and paid each parent/guardian approximately $3,000. The parents/guardians reported that their children received little or no services from Hill or Little, and none of the services billed by Hill/Little from January 2007 to January 2011 were ever properly provided or authorized under Medicaid rules.Using this scheme, Hill and Little unlawfully received approximately $1 million from Medicaid for services they did not provide.

Doctor Sentenced for Health Care Fraud, Pension Fraud and Tax Evasion
On July 17, 2013, in Central Islip, N.Y., Frank Lobacz, a doctor, was sentenced to 65 months in prison and ordered to pay $727,480 in restitution to two private insurance plans and to pay $2,886,454 in federal income tax. On November 13, 2010, Lobacz was convicted of health care fraud, the filing of false pension fund reports with the U.S. Department of Labor and tax evasion during the years 2001 to 2003. According to court documents, Lobacz was a licensed doctor of Osteopathic Medicine with offices in Nassau and Suffolk counties. In the 1970’s, he created a retirement pension plan for himself and his staff, and named himself as the plan administrator in filings with the United States Department of Labor. As the administrator, Lobacz was responsible for filing annual reports on the financial health of the plan and was required to notify the IRS if he or anyone else borrowed or withdrew money from the plan. At trial, witnesses testified that Lobacz engaged in highly complex and risky stock options trading. Between 2000 and 2002, he transferred over $3.5 million in money and stocks to and from the pension plan and his personal brokerage account to pay for personal expenses. Lobacz never reported this misuse of employee pension funds, and between 2000 and 2003, he failed to report over $1 million in options trading income to the IRS. Starting in 2005, to compensate for trading losses, he filed some 1,500 false insurance claims for medical services and procedures purportedly rendered to a retired couple, as well as to Lobacz’s younger children, his wife, and himself. The couple testified at trial that although they received routine acupuncture treatments from the defendant, which would not have been covered under their insurance plans, the bulk of the bills submitted in their names were for services that they either did not receive, or for visits on dates when the couple was traveling outside of New York State. Other fraudulent bills claimed that Lobacz, his wife, and two children received near daily treatments normally provided to those suffering severe respiratory conditions, among other ailments. However, no such treatments or visits actually occurred. In all, Lobacz billed $727,480 in false health care claims to two private health insurance plans.

Texas Ambulance Company Owner and Operator Sentenced for Tax Evasion and Money Laundering
On June 18, 2013, in Houston, Texas, Julian Kimble, of Missouri City, Texas, was sentenced to 72 months in prison, three years of supervised release and ordered to pay $3,676,587 in restitution to the Medicare Program. Kimble pleaded guilty on November 29, 2011 to money laundering and tax evasion. According to court documents, from March 2008 through December 2010, Kimble owned and operated four ambulance companies. Through these companies, Kimble routinely billed Medicare for basic life support ambulance transports that were not provided, not needed or not ordered by the treating physicians. None of these companies operated by Kimble owned licensed ambulance vehicles necessary to provide such transports. Kimble used third-parties and straw owners to register the ambulance companies with the Texas Department of Health. He and others often transported multiple beneficiaries at the same time in vans or sedans and fraudulently billed Medicare for allegedly providing individual transports in ambulances under the attention of qualified emergency medical personnel. Under Kimble’s direction, Medicare beneficiaries received payments in exchange for agreeing to be transported to different facilities around the Houston area. From 2008 through December 2010, Kimble’s companies fraudulently billed Medicare for approximately $8.7 million and received payment for approximately $3.6 million. To conceal proceeds from the health care fraud, Kimble withdrew funds from the business accounts of the ambulance companies, kept part of the funds and used the remainder to pay kickbacks to patients. From August to December 2010, conspirators received checks from Kimble totaling more than $1 million, none of which was reported as taxable income.In addition, Kimble overstated the business expenses for Pearl Ambulance Service on his tax returns for 2003 through 2007.Kimble also failed to file corporate tax returns for Pearl during this time until his assets were about to be seized. When he did file, the delinquent returns were discovered to be materially false.

California Man and His Company Sentenced for Structuring and Money Laundering
On May 24, 2013, in New Orleans, La., Jerayr Rostamian, of Northridge, Calif., was sentenced to 40 months in prison, three years of supervised release and fined $250,000. Rostamian pleaded guilty to structuring monetary transactions to avoid reporting requirements. Med-Tech Technologies, Inc., a company owned by Rostamian, was sentenced to five years of probation and ordered to pay $3,722,480 in restitution to Medicare and Medicaid. In addition, Med-Tech was ordered to forfeit its assets. Med-Tech pleaded guilty to a conspiracy to commit money laundering. According to court documents, Med-Tech participated in a criminal organization for the purpose of fraudulently billing Medicare and Medicaid. Recruiters found patients to bring to medical clinics located in the greater New Orleans area for medical tests that were not performed and not medically necessary. The patients were moved between various clinics and repeatedly had the same unnecessary tests. The patients received prescriptions for drugs, usually narcotics, for their cooperation, and the recruiters were provided cash and prescription drugs for their services. Once Medicare and Medicaid paid the clinics, Med-Tech engaged in a series of financial transactions designed to disguise the fact that the money had been obtained unlawfully and to hide the funds from Medicare and Medicaid. After the fraudulent funds from the clinics were deposited into bank accounts, Rostamian withdrew much of the funds in cash, in amounts just below the threshold so as not to trigger the bank to file a report with the government.

Former Nigerian Fugitive Sentenced for Health Care Fraud and Money Laundering
On May 10, 2013, in Houston, Texas, Godwin Chiedo Nzeocha, a naturalized United States citizen originally from the Federal Republic of Nigeria, was sentenced to 109 months in prison and ordered to pay more than $26 million in restitution to Medicare and Medicaid, jointly with his co-conspirators. In addition, Nzeocha agreed to forfeit $1,098,320 to the United States. Nzeocha pleaded guilty on October 19, 2012 to one count of conspiracy to commit health care fraud and one count of money laundering. According to court documents, Nzeocha left the United States in 2009 to avoid arrest after receiving a telephone call from a City Nursing co-conspirator the day Umawa Imo, owner of City Nursing Services of Texas Inc., was arrested. Nzeocha had an agreement with Imo to sign his name on City Nursing patient documents as the provider of physical therapy services that he knew he was not qualified to authorize. The documents included blank treatment data forms, progress notes and daily physical therapy records. Nzeocha further admitted to knowing Imo was buying Medicare beneficiary information from recruiters and paying Medicare beneficiaries cash in order to bill for physical therapy services that were not provided. Nzeocha received approximately $1,098,320 from City Nursing. Between December 3, 2007 and June 26, 2009, when Nzeocha worked at City Nursing, the company billed Medicare and Medicaid for approximately $35,819,508 worth of physical therapy services that were not provided and received approximately $26,233,122 as payment for those services from Medicare and Medicaid. Imo was sentenced in October 2011 to 327 months in prison.

Leader of Medicaid Fraud Conspiracy Sentenced for Fraud and Money Laundering
On May 6, 2013, in Statesville, N.C., Betty Ann Cook, of Sparta, N.C., was sentenced to 40 months in prison, two years of supervised release and ordered to pay $325,820 in restitution. On April 25, 2012, Cook pleaded guilty to one count of health care fraud conspiracy and one count of money laundering conspiracy. According to court documents, Cook was the owner of Families First Home Health Care, a home health care company located in Alleghany Co., N.C. Cook’s company was enrolled with Medicaid to provide personal care services to Medicaid recipients. These services are provided by a home health aide in the recipient’s home. From December 2006 to about October 2010, Cook participated in a scheme to defraud Medicaid by submitting false and fraudulent claims to Medicaid seeking reimbursement for patient care services that were either not provided, not authorized by a physician, or were not based upon a valid in-home eligibility assessment performed by a qualified registered nurse, as required by Medicaid policy.

Ohio Doctor Sentenced on Health Care Fraud and Tax Charges
On March 25, 2013, in Toledo, Ohio, Darrell A. Hall, a medical doctor, was sentenced to 60 months in prison. Hall pleaded guilty to conspiracy to distribute a controlled substance, health care fraud and a tax count. According to court documents, Hall was licensed to practice medicine and operated a practice under the name “EDM Health Services, LLC.” He was also a registered provider to Ohio Medicaid, which provides free health benefits to qualified low-income Ohio residents. Between August 2008 through May 2009, Hall conspired with others to distribute 1,300 pills of oxycodone for no legitimate medical purpose. In addition, between January 2007 and December 2009, he fraudulently billed Ohio Medicaid in the amount of $78,113. Hall also failed to pay $97,384 in taxes that he owed to the IRS on behalf of EDM Health Services, LLC, between 2007 and 2010.

Doctor Sentenced for Health Care Fraud and Tax Evasion
On March 1, 2013, in Wheeling, W.Va., Barton Joseph Adams, of Parkersburg, W.Va., was sentenced to 50 months in prison for health care fraud and tax evasion.Adams was also ordered to forfeit $3,724,721 to the federal government and to pay $3,136,293 in restitution to various healthcare providers, including Medicare and Medicaid. According to court documents, Adams, a doctor of osteopathic medicine, owned and operated “Interventional Pain Management” in Vienna, W.Va. Adams previously admitted to making fraudulent claims for health care proceeds and to willfully attempting to evade taxes. Josephine Adams, the wife of Dr. Adams, was convicted of assisting her husband in the laundering of nearly $4 million dollars of health care fraud proceeds. The evidence presented showed that the fraud proceeds were first deposited into accounts in West Virginia and then were moved into accounts around the United States before being placed into accounts in Canada, China and the Philippines.

Texas Podiatrist Sentenced for Health Care and Tax Fraud

On January 31, 2013, in Sherman, Texas, Shannon Gallentine, of Maypearl, Texas, was sentenced to 24 months in prison and ordered to pay restitution in the following amounts: $407,942 to the IRS, $254,377 to Medicare, $110,622 to Medicaid, and $26,628 to Blue Cross Blue Shield. Gallentine pleaded guilty on May 10, 2012, to one count of health care fraud and one count of failing to file an income tax return. According to court documents, from January 2004 through May 2007, Gallentine, a podiatrist, owned and operated Ambulatory Foot Care in Lancaster, Texas. During this time, Gallentine submitted false and fraudulent claims to Medicare seeking reimbursement for procedures he did not perform. As a result of these false claims, Gallentine received in excess of $365,000 to which he was not entitled. Additionally, Gallentine willfully failed to file federal income tax returns for calendar years 2004 and 2005.

Florida Chiropractor Sentenced for Conspiracy to Commit Mail Fraud in Connection with Staged Accident Scheme
On January 31, 2013, in Miami, Fla., Jennifer Adams, of Boca Raton, was sentenced to 54 months in prison, three years of supervised release and ordered to pay $1,920,424 in restitution. Adams, a chiropractic doctor, pleaded guilty to a one-count Information charging her with conspiring with others to commit mail fraud for her role in a staged accident fraud scheme. According to court documents, to execute the fraud scheme, recruiters sought out drivers and their friends and family members to participate in staged accidents.Accident participants were directed by the recruiters to chiropractic clinics that were controlled by co-defendants.Adams agreed to place her name on the corporate paperwork for two clinics, thus utilizing her status as a licensed chiropractic physician, to allow the clinics to bill insurance companies directly for claims without obtaining additional licensure from the State of Florida. Adams initially believed the clinics to be operating legitimately. Sometime thereafter, Adams became aware that her license and status as a chiropractor was being used to fraudulently submit claims to insurance companies. Adams realized these patients did not require the medical treatment they sought. Adams continued to work at both clinics signing prescriptions for plans of treatment that she knew were not medically necessary and that she knew were being submitted for reimbursement to numerous insurance companies.From the time that Adams was told about the fraud until the clinics were closed by law enforcement, the clinics submitted fraudulent claims that resulted in more than ten insurance companies making total payments of $1,920,424.

California Doctor Sentenced for Role in Medicare Scam
On December 17, 2012, in Los Angeles, Calif., Dr. Kenneth Thaler, of Westminster, was sentenced to 12 months in prison and ordered to pay approximately $11 million in restitution to the Medicare program. According to court documents, Thaler admitted homeless patients to the Tustin Hospital and Medical Center after they had been driven from “Skid Row” in downtown Los Angeles as part of a Medicare fraud scheme. Thaler admitted approximately 60 patients per month, including some who did not require hospitalization. The patients were recruited by marketers who were being paid kickbacks by recruiters such as Estill Mitts to refer homeless Medicare and Medi-Cal beneficiaries for in-patient hospital stays. After Thaler admitted these patients, he and the hospital billed Medicare and Medi-Cal for in-patient services, even if it was not medically necessary for the patient to be hospitalized. Mitts who operated a center that recruited homeless people to receive unnecessary health services pleaded guilty in September 2008 to conspiracy to commit health care fraud, money laundering and tax evasion. He is awaiting sentencing.

Defendant Sentenced in Multi-Million Dollar Health Care Fraud Case
On November 5, 2012, in Houston, Texas, Tony Nnonso Obi, a naturalized U.S. citizen from the Federal Republic of Nigeria, was sentenced to 41 months in prison for his role in a massive health care fraud that billed the Medicare and Medicaid programs for more than $45 million. Obi pleaded guilty in August 2012 to one count of conspiracy to commit health care fraud and one count of money laundering. As part of his plea, Obi admitted entering into an agreement with Umawa Imo, the owner of City Nursing, to receive 15 percent of the money City Nursing obtained from Medicare for services billed on individuals referred by Obi. Imo paid Obi $1,051,425. Imo is currently serving more than 27 years in prison for his role in the conspiracy.

Michigan Physical Therapist Sentenced on Health Care Fraud and Money Laundering Charges
On October 29, 2012, in Grand Rapids, Mich., Chyawan Bansil, a physical therapist from Farmington Hills, Michigan, was sentenced to 13 months prison, one year of supervised release, and ordered to pay almost $250,000 in back taxes. In addition, Bansil forfeited over $500,000 in assets which had been seized by the government and paid an additional $2.25 million dollars to resolve related civil claims under the False Claims Act. Bansil will also be excluded from participating with Medicare and Medicaid for a minimum of five years. According to court documents, between February 2007 and January 2012, Bansil defrauded Medicare, Medicaid, and Blue Cross Blue Shield of Michigan of more than $1 million by causing those programs to be billed for expensive nerve conduction studies and needle electromyography tests that Bansil did not perform. Bansil was also laundering the proceeds of his fraud scheme in order to avoid taxes

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Be suspicious of doctors, health care providers, or suppliers who:
Ask for your Medicare number:
In exchange for free equipment or services
For “record keeping purposes”
Tell you that tests become cheaper asmore of them are provided
Advertise “free” consultations to people with Medicare
Call or visit you and say they represent Medicare or the federal government
Use telephone or door-to-door selling techniques
Use pressure or scare tactics to sell you expensive medical services or diagnostic tests
Bill Medicare for services you never received or a diagnosis you do not have
Offer non-medical transportation or housekeeping as Medicare-approved services
Bill home health services for patients who are not confined to their home, or for patients who still drive a car
Bill Medicare for medical equipment for people in nursing homes
Bill Medicare for tests you received as a hospital inpatient or within 72 hours of admission or discharge
Bill Medicare for a power wheelchair or scooter when you don’t meet Medicare’s qualifications
Identity theft

Identity theft happens when someone uses your personal information without your consent to commit fraud or other crimes. Personal information includes your name, Social Security, Medicare, or credit card numbers.

The crime takes many forms. Identity thieves may rent an apartment, obtain a credit card, or establish a telephone account in your name. You may not find out about the theft until you review your credit report or a credit card statement and notice charges you didn’t make—or until you’re contacted by a debt collector.

Identity theft is serious. While some identity theft victims can resolve their problems quickly, others spend hundreds of dollars and many days repairing damage to their good name and credit record.

Protect yourself. Keep your personal information safe. Don’t give your information out over the Internet, or to anyone who comes to your home (or calls you) uninvited. Give personal information only to doctors or other Medicare approved providers.

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Consent is the difference between sanctioned sexual conduct and criminal sexual conduct. If one party cannot, or makes clear that he or she does not, want to partake in sexual contact with another party, his or her wishes must be respected. If the acting party instead continues to engage in sexual contact with his or her victim, he or she may be charged with sexual assault. If the crime meets certain circumstances outlines in N.J.S.A. 2C:14-3, he or she also faces criminal sexual conduct charges.

Criminal sexual conduct laws exist to prevent sexual assaults against children and people with disabilities by making the punishments for assaults against these groups harsher. These charges are often added onto sexual assault charges.

In its basic form, criminal sexual conduct is a fourth degree crime. If the defendant is a parent, guardian, or stands in loco parentis to the victim and any of the following circumstances occur, he or she may be charged with fourth degree criminal sexual conduct.

The victim is younger than sixteen years old.

The sexual action is committed during a successful or attempted robbery, arson, burglary, kidnapping, homocide or criminal escape.

The perpetrator uses a weapon or object that could ostensibly be used as a weapon to to coerce the victim into allowing sexual contact.

The penalties for a fourth degree criminal sexual conduct charge are a jail sentence of up to eighteen months and a fine of up to $10,000. Any person convicted of criminal sexual conduct may also be subject to Megan’s Law requirements and community supervision for the remainder of his or her life.

The charges raise to aggravated criminal sexual conduct, a third degree crime, if the defendant commits an act of sexual penetration and any of the following conditions are met:

The victim is between thirteen and sixteen years old

The act is committed during a successful or attempted robbery, burglary, homocide, arson, kidnapping or criminal escape.

The offender possesses or threatens to use a weapon or object that could reasonably be used as a weapon to extort sexual contact from his or her victim.

The offender knew the victim was physically or mentally incapable of defending him- or herself against the attack, whether permanently or temporarily.

Third degree crimes are punishable by three to five years in jail and fines of up to $150,000. Like fourth degree criminal sexual conduct convictions, offenders guilty of aggravated criminal sexual conduct are subject to lifelong supervision and Megan’s Law requirements.

Megan’s Law is an act that was signed into law in 1994 that requires sex offenders to register with a database that allows law enforcement to see where they live and make their presence in a neighborhood known to the public. In 2001, Megan’s Law was updated to include an internet registry requirement. The law is named for Megan Kanka, a seven-year-old New Jersey girl who was raped and murdered by her neighbor in 1994. Recent studies have had mixed results about the effectiveness that Megan’s Law has had on lowering sex crime rates. Despite the questionable outcome Megan’s Law has had on New Jersey communities, it continues to be a part of most sexual assault and criminal sexual conduct convictions. Convicted sex offenders must register with the Sex Offender Registry for the rest of their lives. Failing to register is a fourth degree crime.

Actions considered to be sexual in nature are the touching of the breasts, genitals, buttocks, groin, inner thighs and anal area. Touching can be direct or through the victim’s clothing. To be considered criminal sexual contact, the touching must be done intentionally and with the purpose to either degrade or humiliate the victim, or around or sexually gratify the offender. The victim’s age is a key part of determining the criminality of a sexual act because it is illegal for an adult to have sexual contact with a child under the age of sixteen in New Jersey. Additional language in N.J.S.A. 2C:14-2 states age of consent laws for relationships where both parties are younger than eighteen years old. For adults over the age of eighteen, sexual contact with any person younger than sixteen is illegal, regardless of whether or not the minor consented to sexual contact.

If you have been accused of criminal sexual conduct, do not take this accusation lightly. A sexual conviction can haunt you for the rest of your life and restrict you from performing certain jobs. Don’t risk losing this fight – choose an experienced criminal attorney who understands New Jersey sexual law and will help you build a case to prove your innocence. Call Ron Bar-Nadav, Esq. Today at 201-525-1555. Let him be your guide through this difficult, confusing process. Don’t wait – your life and career depend on it.

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Theft is the act of stealing another person’s property. Property, as used here, can be anything that another person has a claim to own or provide – merchandise in a store he or she owns, personal property, services provided, and one’s identity.

In its most basic form, the severity of a theft and degree of its subsequent charge are determined by the monetary value of the property taken from the victim. If the value of the property is $75,000 or greater, the defendant may be charged with a second degree crime. If the property’s value is between $500 and $75,000, the defendant may be charged with a third degree crime. A theft is a fourth degree crime if the value of the property stolen is between $200 and $500. Any theft of property worth less than $200 is a disorderly persons offense.

Not every theft is graded strictly according to the value of the property stolen, though. Certain items or actions taken during a theft automatically garner a specific degree of crime during prosecution, regardless of their actual monetary worth.

If any of the following conditions are met, a theft is automatically charged as a second degree crime.

The property is taken through extortion, which is the act of obtaining something through force or a threat.

The stolen property is one kilogram or more of any illegal drug.

The stolen property is any type of human remains

Health care benefits worth $75,000 or more are fraudulently received.

Second degree theft convictions are punishable by a prison sentence of five to ten years and/or a fine of up to $150,000, or double the amount the victim lost, whichever is higher.

Third degree charges apply in all of the following theft scenarios:

The property stolen is any illegal drug worth less than $75,000.

The property stolen is less than one kilogram of any illegal drug.

The stolen property is a horse, airplane, boat, automobile, firearm, or domestic pet.

The property is a public record.

The property is part of a research project.

The property is a blank prescription script.

The property is any type of access device.

Health care benefits of valued at less than $75,000 are stolen.

Anhydrous ammonia is stolen to be used to make methamphetamine.

Third degree theft convictions are punishable by three to five years in jail, and/or a fine of up to $15,000 or double the amount of money the victim lost as a result of the theft, whichever is higher.

Defendants who are convicted of fourth degree theft face up to eighteen months in jail and a fine of up to $10,000. They may also be fined double the amount of money or value of the victim’s loss, if this is higher.

Thefts classified as disorderly persons offenses are punishable by imprisonment for up to six months and/or a fine of up to $1,000 or double the amount of money the victim has lost.

Identity theft is unique among the types of theft recognized by New Jersey law because it involved fraud on the part of the thief, rather than the outright taking of another’s property. It is the act of using another person’s name or other personal identification to gain money or other advantages.

If an identity thief victimizes two to four people or the amount of money lost as a result of identity theft is between $500 and $75,000, the defendant may be charged with a third degree crime. The penalties are three to five years in jail plus restitution payments to the victim or victims for any money illegally gained.

Identity theft is second degree crime if it is committed against five or more people or if the total value gained is $75,000 or more. Second degree identity thefts are punished by five to ten years in jail and required restitution payments.

Any person who steals an automobile faces additional penalties. The first time an offender is convicted of stealing a car, he or she will have his or her driver’s license suspended for one year and must pay a $500 fine. For a second offense, the defendant’s driver’s license is suspended for two years, and the fine amount raises to $750. If the same offender commits and is convicted of a third vehicle theft, he or she loses his or her driver’s license for ten years and must pay a $1,000 fine. If the vehicle stolen is valued at $7,500 or higher, the defendant may have to pay a higher fine.

The money paid to theft victims by the offender is called restitution. Only second degree theft convictions require the defendant to pay restitution to his or her victim following the cases’ settlement.

If you or someone you know has been charged with theft, call Ron Bar-Nadav at 201-525-1555 today to discuss your charge’s specific details and being building a case. If you want to defend yourself in court, you have to be proactive. Take that first step and call Ron Bar-Nadav today.

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