May 12, 2010
Office of The Attorney General
– Paula T. Dow, Attorney General
Division of Criminal Justice
– Stephen J. Taylor, Director
Office of the Insurance Fraud Prosecutor
– Riza Dagli, Acting Insurance Fraud Prosecutor
Media Inquiries-
609-292-4791
Citizen Inquiries-
609-292-4925
Owner of Counseling Center Charged With Defrauding Medicaid of Hundreds of Thousands of Dollars
TRENTON – Attorney General Paula T. Dow and Criminal Justice Director Stephen J. Taylor announced that the owner of a now-defunct Newark mental health and substance abuse counseling center has been indicted for allegedly defrauding Medicaid of hundreds of thousands of dollars.
According to Acting Insurance Fraud Prosecutor Riza Dagli, Rostislav Vilshteyn, a.k.a. Steve Vilshteyn, 31, of Staten Island, New York, was charged yesterday (May 11) with second-degree health care claims fraud and two counts of third-degree Medicaid fraud.
The state grand jury indictment alleges that between October 2006 and January 2008, as the owner and operator of Bloomfield Health Pavilion LLC, formerly located at 86 Bloomfield Avenue in Newark, Vilshteyn submitted or caused to be submitted to the Medicaid program claims for reimbursement for health care or counseling services for numerous Medicaid beneficiaries, even though the services had either not been provided or had not been provided to the extent alleged in the claims.
The investigation revealed that Vilshteyn submitted more than $1.2 million in claims to the Medicaid program, for which he was paid $574,504. It is alleged that hundreds of thousands of dollars of those payments were obtained by Vilshteyn through fraudulent claims.
The indictment further alleges that Vilshteyn offered “kickbacks” in the form of Pathmark gift certificates in order to induce Medicaid beneficiaries to appear at Bloomfield Health Pavilion. He allegedly submitted fraudulent claims related to those beneficiaries. One of the counts of Medicaid fraud is charged under the state’s “anti-kickback” statute.
Detective Laura Pezzuti and Deputy Attorney General Cynthia M. Vazquez were assigned to the investigation. Deputy Attorney General Vazquez presented the case to the state grand jury. Acting Prosecutor Dagli thanked Investigator Joseph Varone and Nurse Investigator Janet Keenan of the Office of the Medicaid Inspector General, as well as Analyst James Harris of the Division of Medical Assistance and Health Services for their assistance in the investigation.
The indictment is merely an accusation and the defendant is presumed innocent until proven guilty. Second-degree crimes carry a maximum sentence of 10 years in state prison and a criminal fine of $150,000, while the crime of third-degree Medicaid fraud carries a maximum sentence of three years in state prison and a criminal fine of $10,000.
Acting Fraud Prosecutor Dagli 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 1-877-55-FRAUD or visiting the Web site www.njinsurancefraud.org. State regulations permit an award to be paid to an eligible person who provides information that leads to an arrest, prosecution and conviction for insurance fraud.
The Office of Insurance Fraud Prosecutor was established by the Automobile Insurance Cost Reduction Act of 1998. The office is the centralized state agency that investigates and prosecutes both civil and criminal insurance fraud, as well as Medicaid fraud.
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