BRICK TOWNSHIP — A former township employee pleaded guilty Tuesday to stealing almost $1 million from the township’s health insurance program by allowing a health care practitioner submit false claims in her name, according to Attorney General Christopher S. Porrino.
Kim E. Bogan, 52, of Brick, pleaded guilty to second-degree theft by deception before Superior Court Judge Linda G. Baxter in Ocean County, Porrino said.
As part of the plea agreement, the state will recommend five years in prison when she is sentenced Jan. 2, 2018. She is also required to pay $941,354 in restitution to the township, according to Porrino and and the Office of the Insurance Fraud Prosecutor.
Bogan worked in the township’s Building Department. She admitted to helping an out-of-state health care practitioner submit false claims to her health insurance program, self-funded by Brick Township, between January 2011 and April 2017, Porrino said. The claims were for treatments allegedly given to individuals covered under Bogan’s policy.
Bogan’s case shares a few similarities with a federal investigation focused on a scheme in which public employees in several Atlantic County shore towns were recruited to obtain medically unnecessary prescriptions throught their state health insurance plan. Federal authorities say the scheme defrauded the state’s benefits plan of more than $25 million. Ten people have pleaded guilty so far and the investigation continues. The scheme involved doctors, pharmacy representatives and public employees — teachers, firefighters, municipal police officers and State Police troopers.
In exchange for the prescriptions, the recruiters and the doctors receive kickbacks from the out-of-state compounding pharmacy and pay co-conspirators, documents say.
Porrino said Bogan allowed the practitioner to submit claims in her name for services never rendered, and “endorsed the insurance checks when they were mailed to her, knowing the money was stolen.
“What’s even more disturbing is that she went along with the scheme knowing that the taxpayers of Brick Township — her friends and neighbors — would be responsible for picking up the tab for the bogus claims,” Porrino said.
“This township employee stole money meant to cover health care services for her co-workers and their families,” said acting Insurance Fraud Prosecutor Christopher Iu. “We will continue to aggressively investigate and prosecute this kind of claims fraud to protect these resources for those who legitimately need them.”
Deputy Attorney General Thomas G. Tresansky Jr. represented the state in the plea hearing. Detectives Cortney Lawrence and Jared England coordinated the investigation. Township Administrator Joanne Bergin, Horizon Blue Cross Blue Shield Special Investigations Unit Senior Investigator Catherine Nielsen, supervisor James Howell and manager Megan McCarthy assisted in the investigation.