TRENTON – Attorney General Matthew J. Platkin and the Office of the Insurance Fraud Prosecutor (OIFP) announced today that the State has seized approximately $6.4 million under a final judgment by consent, resolving a case against a now-deceased defendant whose chain of mental health clinics in Essex, Hunterdon, Mercer, Union, and Warren counties engaged in an elaborate bogus-billing scheme that defrauded Medicaid.

The late defendant, Daniel E. Cassell, formerly of Perkasie, Pennsylvania, was named in a 17-count indictment in August 2022, charging him with 16 counts that included financial facilitation of criminal activity, conspiracy, health care claims fraud, Medicaid fraud, theft by deception, and other charges.

The case was initiated after a referral from the Medicaid Fraud Division of the Office of the State Comptroller. The indictment stated that between January 2015 and October 2020, Cassell, who was the president and chief executive officer of Kwenyan Professional Health Services based in West Orange, as well as Kwenyan and Associates, based in Ewing (the “Kwenyan entities”), was responsible for the submission of thousands of false claims to Medicaid for reimbursement.

While Cassell died in December 2022, the consent judgment comes after the admission by the Kwenyan entities that they presented fraudulent claims to Medicaid for services not rendered to numerous Medicaid beneficiaries. The Kwenyan entities entered that admission in open court on November 2, 2023, before Superior Court Judge Regina Caulfield in Union County. Further, these entities obtained medical assistance payments to which they were not entitled. The Kwenyan entities submitted to the New Jersey Division of Medical Assistance and Health Services more than 10,000 false claims where no actual services were rendered, or where group therapy services were performed, but higher-paying individual therapy or family psychotherapy codes were falsely billed.

The final judgment by consent, paired with additional disposition of property and rent collected, reflects the State seizure and forfeiture of 15 passenger vans; $2,437,546 in funds from financial accounts; $3,922,532 in funds related to the sale of properties in Flemington, West Orange, and Washington Township, New Jersey; and the collection of $47,879 in rent on five parcels of real estate, for a total seizure of approximately $6,407,958. The State will be entitled to further proceeds after the sale of other real estate maintained by Cassell and the Kwenyan entities. All seized and collected funds are remitted to the State Treasurer.

“This was not a small number of illegitimate claims for payment, but rather the systematic submission of false claims — thousands of them — over several years, defrauding taxpayers of millions of dollars,” said Attorney General Platkin. “The judgment in this case should serve as a warning to providers who bill Medicaid for services that are not delivered: we will not only prosecute fraud, but also make every effort to recover money that was stolen from the public.”

“The hard work of the detectives and attorneys who handled this case led to the return of over $6 million in assets to the State,” said Interim Insurance Fraud Prosecutor Al Garcia. “This case demonstrates my Office’s commitment to seeking out fraud and ensuring our Medicaid programs are protected.”

Deputy Attorneys General (DAsG) Vladimir D’Argenio and Charisse M. Penalver prosecuted the case for the Office of the Insurance Fraud Prosecutor – Medicaid Fraud Control Unit (OIFP-MFCU), under the supervision of Assistant Bureau Chief Michael Klein and Bureau Chief Heather Hadley. Detective Michael Rosati led the investigation under the supervision of Sgt. Matthew Armstrong, Lt. Joseph Jaruszewski, and Deputy Chief Rich King. The civil asset forfeiture proceedings were handled by DAsG Leslie-Ann M. Justus and Laticia M. Wright in OIFP’s Case Screening, Litigation, and Analytical Support Section (CLASS) under the supervision of OIFP Chief of Staff AAG Nina D. Bonner. The following agencies assisted OIFP with this case: the New Jersey Department of Treasury, Division of Taxation, Office of Criminal Investigation; the Hilltown Township Police Department, Hilltown, Pennsylvania; U.S. Customs and Border Protection, U.S. Department of Homeland Security; and the Clayton County Sheriff’s Office, Jonesboro, Georgia. Interim Insurance Fraud Prosecutor Garcia thanked all the agencies that assisted with this case, especially the Medicaid Fraud Division of the Office of the State Comptroller for the referral.

New Jersey MFCU’s total funding for federal fiscal year (FY) 2023 is $9,418,641. Of that total, 75 percent, or $7,063,984, is awarded under a grant from the U.S. Department of Health and Human Services. The remaining 25 percent, totaling $2,354,657 for FY 2023, is funded by the State of New Jersey.

OIFP’s Medicaid Fraud Control Unit specifically protects Medicaid beneficiaries and the Medicaid Program from fraud, waste, and abuse. Further, the Unit may review complaints of abuse or neglect of patients or residents in care facilities regardless of the funding source. To report fraud, abuse or neglect, please email NJMFCU@njdcj.org  or call 609-292-1272. If you are concerned about insurance cheating in general, and have information about insurance fraud, you can report fraud anonymously by calling the toll-free hotline at 1-877-55-FRAUD, or visiting www.NJInsurancefraud.org. State regulations permit a reward to be paid to eligible persons who provide information that leads to an arrest, prosecution, and conviction for insurance fraud.

Insurance Fraud. Report It. End It.

Defense Attorneys:
Zach Intrater, Esq.
Lee Vartan, Esq.