09-22-05 -- Caruso, Robert -- Guilty Plea -- News Release

Former Senior Manager for Non-Profit Nursing Association Admits Health Care Fraud

NEWARK - A former senior manager for the Visiting Nurse Association (VNA) of Central Jersey, Inc. pleaded guilty today to defrauding the non-profit organization and government health care programs of more than $900,000 in a false invoice scheme, U.S. Attorney Christopher J. Christie announced.

Robert Caruso, 53, of Toms River, admitted that, while he was director of administrative support services at VNA in Red Bank, he created non-existent health-care services companies that purportedly provided services to VNA. In fact, Caruso admitted, no such services were provided, and he used the companies to fraudulently bill VNA via other third-party health care providers, according to Assistant U.S. Attorney John M. Vazquez.

Caruso pleaded guilty before U.S. District Judge John C. Lifland to one count of health care fraud, which carries a maximum penalty of 10 years in prison and a fine of $250,000. Judge Lifland scheduled sentencing for Jan. 5.

VNA first reported the fraud to federal authorities and cooperated fully in the investigation of Caruso.

At his plea hearing, Caruso admitted that he approached two companies (the "outside vendors") - both of which provided supplemental health care workers to VNA. Caruso admitted that he entered into agreements with the two outside vendors in which they would bill VNA for services provided by Caruso's companies. But, as Caruso admitted, his companies existed merely on paper, had no employees and provided no services.

According to the one-count Information to which Caruso pleaded guilty, between October 2000 and September 2004, Caruso regularly provided the two outside vendors with false and fraudulent invoices from the Caruso companies for health care services. The two outside vendors, in turn, submitted the invoices to VNA for payment. According to the Information and Caruso's admissions to the Court, VNA mailed checks to the outside vendors. VNA also billed Medicaid and Medicare in connection with the fraudulent invoices.

Caruso then received payment for the false invoices through the two outside vendors, which also kept an administrative fee.

As a result of the scheme, according to the Information, Caruso caused VNA to sustain losses of more than $900,000, of which more than $450,000 had been paid by Medicaid and more than $40,000 had been paid by Medicare.

U.S. Attorney Christie credited Special Agents of the FBI, under the direction of Special Agent in Charge Leslie Wiser, Jr., and Postal Inspectors with the U.S. Postal Inspection Service, under the direction of Postal Inspector in Charge Thomas C. Van de Merlen, both in Newark.

The case was prosecuted by Assistant U.S. Attorney Vazquez, of the U.S. Attorney's Office Securities and Health Care Fraud Unit, in Newark.

-end-

Defense Counsel:

Edward Dimon, Esq. Toms River