Milo Carl Dorsainvil, 46, of Orange, was charged with second-degree theft by deception, third-degree theft by deception, third-degree Medicaid fraud, and third-degree tampering with public records or information.
"By his alleged actions, this defendant stole money from governmental programs aimed at helping citizens who truly need help making ends meet," Insurance Fraud Prosecutor Ronald Chillemi said. "My office will continue to investigate and aggressively prosecute individuals who engage in this type of fraud."
The state grand jury indictment alleges that between Nov. 25, 2008 and Jan. 31, 2012, Dorsainvil fraudulently obtained $116,219 in Medicaid benefits by failing to notify the Social Security Administration that he was employed and by making false claims that he was entitled to Medicaid benefits.
The indictment further alleges that between July 1, 2005 and Dec. 1, 2011, Dorsainvil fraudulently obtained $47,562 in Supplemental Security Income (SSI) by giving the false impression that he was unemployed. SSI is a needs-based federal and state program that makes payments to people with “limited income” if they are disabled or over 65 years of age.
Lastly, the indictment alleges that in October 2010, Dorsainvil failed to list his income on a statement for determining continuing eligibility for SSI payments.
An investigation by the Office of the Insurance Fraud Prosecutor and the Social Security Administration - Office of the Inspector General determined that, between June 2005 and January 2012, Dorsainvil was actually employed as a bus driver for International Bus Services, which is located in Manhattan.
The investigation determined that Dorsainvil allegedly used two Social Security numbers – one that he used for his employment and the other that he used to receive Supplemental Security Income and Medicaid benefits in order to perpetuate the fraud.
Deputy Attorney General Peter Sepulveda and Detectives Matt Michalik and Laura Catizone were assigned to the case. Acting Insurance Fraud Prosecutor Chillemi thanked the Social Security Administration - Office of the Inspector General, under the direction of Special Agent in Charge of the New York Field Division Edward J. Ryan, for its assistance in the investigation.
The indictment is merely an accusation and the defendant is presumed innocent until proven guilty. Second-degree crimes carry a maximum sentence of ten years in state prison and a criminal fine of up to $150,000, while third-degree crimes carry a maximum sentence of up to five years in state prison and a criminal fine of up to $15,000.
Acting Insurance Fraud Prosecutor Chillemi noted that some important cases have started with anonymous tips. People who are concerned about insurance cheating and have information about a fraud can report it anonymously by calling the toll‑free hotline at 1‑877‑55‑FRAUD, or visiting the Web site at www.NJInsurancefraud.org. State regulations permit a reward to be paid to an eligible person who provides information that leads to an arrest, prosecution and conviction for insurance fraud.