Health benefits

NJ alleges old-fashioned health benefits fraud in Wildwood | Editorial

When we recently saw the words “health benefits fraud” in a headline, our first thought was finally a step towards justice in the massive bribes to public employees in South Jersey for submitting false prescriptions to their generously funded public health care system.

A federal investigation detailed at least $50 million in fraudulent claims, starting in 2015. Of the 200 people involved — including school workers, firefighters and other government workers — many were convicted , but less condemned. The public is rightly concerned after so many years that one side of government might be soft on another side’s offenders who have greedily betrayed the generosity of taxpayers. State and federal authorities should notify the public of the case as soon as possible.

The headline late last month instead announced new charges at Wildwood. Marc Pfeiffer of the Bloustein Local Government Research Center at Rutgers University said the generosity of New Jersey’s $3 billion state health benefit plan provides opportunities for fraud. Three city officials reportedly availed themselves of a familiar old form.

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Mayor Pete Bryon, former Mayor Ernest V. Troiano Jr. and current City Commissioner Steven E. Mikulski have been accused of fraudulently obtaining health coverage from public servants for part-time jobs.

Acting Attorney General Matthew J. Platkin said each was charged with theft by unlawful taking (of the state health benefits program) and falsifying information from public records (in an attempt to give felt like they were working full time).

Platkin said the alleged actions to obtain unwarranted paid health coverage were “violations of public trust” and he promised, “We will work tirelessly to root out public corruption and restore trust in our institutions.”

Just over a decade ago, getting underserved health coverage cheated the paying public, but it wasn’t against state law. Until then, it was common and it was up to the municipalities to put an end to the practice of their agents.

In 2009, Ocean City Mayor Sal Perillo was attacked for proposing to cut health insurance benefits for city council members, who worked part-time. He figured the city and taxpayers would save $150,000 a year.

Absecon and Port Republic had never offered health benefits to their elected part-timers. Galloway Township council members got off to a good start the following year by voting unanimously to eliminate their own health benefits

Pressure mounted on state lawmakers, who were also part-timers with health coverage. That same year, 2010, New Jersey enacted a law requiring elected officials to be full-time employees “whose hours of work are set at 35 or more hours per week” to be eligible for the state health benefits program. State and employer-provided health care.

In Wildwood, the investigation revealed that Byron, Troiano and Mikulski had never been full-time employees under state law. They weren’t given vacation, sick or personal time off, and they didn’t maintain any regular schedules.

Platkin said Troiano and Byron falsely signed and submitted time sheets to the city showing they worked full days Monday through Friday. As a result, Wildwood and the state plan paid more than $286,500 in premiums and claims on Troiano’s behalf from July 2011 through December 2019. For Byron, the state plan paid more than $608,900 in premiums and claims on his behalf from July 2011 to 2021. .

That’s a lot of money and we’re glad to see the Attorney General’s office is pursuing the case.

But the numbers pale in comparison to the tens of millions caught with fraudulent prescriptions mostly for drugs compounded by corrupt benefit managers, doctors and dozens of regular government employees supposed to serve the public, not steal it. We share the general interest in ensuring that this case is also pursued to its proper conclusion.