On Monday, it was announced that the executive director of a nonprofit provider of mental health services had been sentenced to 70 months in prison for defrauding New Jersey Medicaid. 53-year-old Cesar Tavera of Cherry Hill, New Jersey was sentenced for using unqualified individuals to treat Medicaid recipients and taking money from the nonprofit organization. The defendant has previously pleaded guilty to the charges.
Documents and statements confirm that Cesar Tavera was the Executive Director of Nueva Vida Behavioral Health Service. The nonprofit provider of mental health services primarily served the Hispanic community in Camden, New Jersey. Most of the patients were on Medicaid. Tavera was responsible for handling the organization’s billings to New Jersey Medicaid.
He was also in charge of supervising the people responsible for treating the patients. New Jersey Medicaid rules require that professionals must be licensed or have a master’s degree in mental health to provide mental health therapy to Medicaid recipients.
Tavera used several unlicensed and unqualified individuals to treat Medicaid recipients. Then, he billed Medicaid as if the patients were treated by qualified individuals. The defendant even treated Medicaid patients himself, despite not being qualified to do so.
At Tavera’s instruction, Nueva Vida also engaged in several other fraudulent practices. The nonprofit often billed for therapy that never happened. It also billed for group therapy when each patient had received individual therapy. To cover up the behavior, Tavera created false records in hopes of passing Medicaid audits.
The defendant also embezzled money from the nonprofit’s bank account and frequently spent money on himself and his family. He used Nueva Vida’s bank account to pay for meals, travel, dental care and his daughter’s music career. In addition to the 70 months in prison, Tavera has also been sentenced to three years of supervised release. He has also been ordered to pay $2.5 million in restitution.