04/12/2011

News / Manager of Adult Medical Day Care In Atlantic County Pleads Guilty to Health Care Claims Fraud

TRENTON - Attorney General Paula T. Dow and Criminal Justice Director Stephen J. Taylor announced that the manager of an adult day health services facility has pleaded guilty to defrauding the Medicaid program. The facility is no longer in business.

According to Acting Insurance Fraud Prosecutor John Kennedy, Salvatore Chillemi, 50, of Sewell, pleaded guilty yesterday before Superior Court Judge Christine Allen-Jackson in Gloucester County to an accusation that charged him with second-degree health care claims fraud.

Judge Allen-Jackson scheduled sentencing for June 10. Under the plea agreement, the state will recommend that Chillemi be sentenced to three years in state prison. Also, as part of the plea agreement, the state will recommend that Chillemi pay $147,076.14 in fines and penalties. Chillemi will also be barred from participation in the Medicaid program and any other federally or state funded health insurance or prescription assistance program for a term of eight years.

Chillemi served as the manager/director and client outreach coordinator for Shore Winds Adult Medical Day Care, an adult day health services facility located in Somers Point. In pleading guilty, Chillemi admitted that between May 8, 2006, and Nov. 8, 2010, he fraudulently submitted five or more claims for adult day health services valued at a total of more than $1,000, purportedly provided to Medicaid beneficiaries. An investigation by the Office of the Insurance Fraud Prosecutor determined that the services for which the claims were submitted were either not provided, or not provided to the extent for which they were billed.

Detective Joseph Jaruszewski, Detective Jacqueline Latty and Deputy Attorney General Erik Daab, Chief of the Medicaid Fraud Unit, and Deputy Attorney General Oriana Nadraga were assigned to the investigation. Deputy Attorney General Nadraga represented the state at the guilty plea hearing. Deputy Attorney General Carol Stanton Meier is assigned to the asset forfeiture action for the Division of Criminal Justice. Acting Insurance Fraud Prosecutor Kennedy thanked the Department of Health and Senior Services and the Office of the State Comptroller for their assistance in the investigation.

http://www.nj.gov/oag/newsreleases11/pr20110412b.html

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