2 Cherry Hill Men Admit To Medicaid Embezzlement, Authorities Say

CHERRY HILL, NJ — The executive director of a nonprofit provider of mental health services to Camden’s poorest residents and a former therapist who worked at the facility have admitted their respective roles in defrauding New Jersey Medicaid, Acting U.S. Attorney William E. Fitzpatrick said on Friday.

Nueva Vida Behavioral Health Center of New Jersey Executive Director Cesar Tavera, 53, of Cherry Hill, pleaded guilty in federal court to an information charging him with conspiracy to commit health care fraud and with embezzling from a health care benefit program on Thursday.

On Friday, Andres Ayala, 62, of Cherry Hill, pleaded guilty to an information charging him with conspiracy to commit health care fraud.

Nueva Vida Behavioral Health Center of New Jersey is a nonprofit provider of mental health services to the Camden Hispanic community. Most of Nueva Vida’s patients are on Medicaid, and Tavera controlled Nueva Vida’s billings to New Jersey Medicaid, according to documents filed in the case and statements made in court.

He also supervised the people at Nueva Vida who treated Medicaid patients. New Jersey Medicaid rules require that people giving mental health therapy to Medicaid recipients must either be licensed or have a master’s degree in mental health.

However, Tavera had several unlicensed, unqualified individuals treat Medicaid recipients and then billed Medicaid as if qualified therapists had given the treatments, according to authorities. In fact, Tavera admitted to treating Medicaid patients even though he was not qualified.

Under Tavera’s direction, Nueva Vida used several other fraudulent practices to obtain money from Medicaid, authorities said. Nueva Vida billed Medicaid for therapy that never happened and billed group therapy as if each participant received individual therapy.

For example, if a mother received therapy without her child, Nueva Vida would bill Medicaid for a session with the mother and a separate session with the child.

Nueva Vida billed Medicaid for short sessions as if they lasted for 45 minutes. To cover up his crimes, Tavera admitted he created false records to pass Medicaid audits.

He regularly embezzled money from the Nueva Vida bank account in addition to his salary and spent the money on himself and his family, authorities said. He used the Nueva Vida bank account to pay for dental care, meals, travel in the United States and abroad, and the expenses of his daughter’s music career.

Tavera paid no-show employees with cash and payroll checks from 2 Nueva Vida’s bank account. He repeatedly withdrew cash at the Sugar House Casino in Philadelphia and used the money to gamble at the casino. In all, authorities said Tavera embezzled more than $1.5 million from Nueva Vida.

Ayala was a therapist at Nueva Vida for many years. He conspired with Tavera to submit false bills to New Jersey Medicaid.

For example, if patients did not show up for their appointments, Ayala would have Nueva Vida bill Medicaid, and he was paid for the phantom session. If a mother came for therapy, Ayala would bill for a therapy session with the child. If he saw a Medicaid patient for 10 to 15 minutes, he would bill Medicaid for 45 minutes of therapy. In all, authorities said Ayala was responsible for $200,000 in losses to Medicaid.

The counts of health care fraud and embezzlement each carry a maximum penalty of 10 years in prison and a fine of the greater of $250,000 or twice the gain or loss caused by the offense. Tavera and Ayala are both scheduled to be sentenced on Aug. 18.

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