Cherry Hill Man Who Used Unqualified Healthcare Workers To Swindle Medicaid Sentenced

CHERRY HILL, NJ — The executive director of a nonprofit provider of mental health services to Camden’s poorest residents has been sentenced to four years, 10 months in for defrauding New Jersey Medicaid by using unqualified people to treat Medicaid recipients and taking money from the nonprofit, Acting U.S. Attorney William E. Fitzpatrick announced on Monday.

Cesar Tavera, 53, of Cherry Hill, previously pleaded guilty to an information charging him with conspiracy to commit health care fraud and embezzling from a healthcare benefit program. He was also sentenced to three years supervised release and must pay $2.5 million in restitution.

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.

Image via Shutterstock