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Teaneck Man Charged with Insurance Fraud

the staff of the Ridgewood blog 

Trenton NJ, Attorney General Gurbir S. Grewal and the Office of the Insurance Fraud Prosecutor today announced that a Bergen County man has been charged with insurance fraud and theft by deception in an alleged scheme to collect $17,048 in temporary total disability payment from his insurance company.

Ramdeo Ramsaran, 54, of Teaneck, was indicted on charges of second-degree insurance fraud and third-degree theft by deception in an indictment handed up by a state Grand Jury in Trenton on December 12.

According to the indictment, between August 2016 and July 2017 Ramsaran collected temporary total disability payments from Hudson Insurance Company by falsely claiming he was unable to work when, in fact, he was working.

Ramsaran allegedly made false statements and submitted, or caused to be submitted, fraudulent documents in support of that claim.

Second-degree crimes carry a sentence of five to 10 years in state prison and a criminal fine of up to $150,000; third-degree crimes carry a sentence of three to five years in state prison and a criminal fine of up to $15,000. The indictment is merely an accusation and the defendant is presumed innocent until proven guilty.

Deputy Attorney General Jennifer Menjivar presented the case to the Grand Jury. Detective Wendy Berg coordinated the investigation.  

Acting Insurance Fraud Prosecutor Thompson thanked Hudson Insurance Company for referring the matter to OIFP.

Acting Insurance Fraud Prosecutor Thompson 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 a conviction for insurance fraud.

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Shooting in Bogota Leaves One Dead

the staff of the Ridgewood blog

Bogota NJ, Acting Prosecutor Dennis Calo announces the following information:

The Bergen County Prosecutor’s Office Major Crimes Unit, the Bogota Police Department, and other local agencies are investigating a fatal shooting that occurred early this morning, December 12, 2018, in Bogota, NJ.  

At approximately 1:43 a.m., the Bogota Police Department received a 9-1-1 call of shots fired outside Buddy’s Bar, 13 East Fort Lee Road, Bogota, NJ.  Officers from the Bogota, Teaneck, and Ridgefield Park Police Departments responded to the scene, where they found a 28-year-old male on the front lawn of a nearby house, 286 Leonia Avenue, Bogota, suffering from a single gunshot wound.  The victim was transported to Hackensack University Medical Center, where he was pronounced dead.

The suspects fled the scene.  The investigation is ongoing, and more information will be released at a later time. 

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Valley Hospital Settles Suit with Horizon Blue Cross and Blue Shield of New Jersey

Valley Hospital

the staff of the Ridgewood blog

Ridgewood NJ, the Valley Hospital has settled with Horizon Blue Cross and Blue Shield of New Jersey the day before a trial was set to begin on allegations that the insurer pushed smaller community hospitals out of the market, according to NJ.com.

Continue reading Valley Hospital Settles Suit with Horizon Blue Cross and Blue Shield of New Jersey

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TEANECK MAN CHARGED WITH CYBER-HARASSMENT

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the staff of the Ridgewood blog

Teaneck NJ, Acting Bergen County Prosecutor Dennis Calo announced the arrest of August H. SAMEK (DOB: 7/2/1998; single; unemployed) of 208 Colonial Court, Teaneck, NJ, on a charge of Cyber-Harassment. The arrest is the result of an investigation conducted by the Bergen County Prosecutor’s Office under the direction of Chief Robert Anzilotti.

Continue reading TEANECK MAN CHARGED WITH CYBER-HARASSMENT

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Teaneck Man Charged With Embezzlement from Employee Benefit Plan

the staff of the Ridgewood blog

Teaneck NJ,  A Bergen County, New Jersey, man who served as a trustee of a pension fund was charged with embezzling more than $180,000 from an employee benefit fund, U.S. Attorney Craig Carpenito announced today.

Howard Preschel, 62, of Teaneck, New Jersey, is charged by complaint with one count of embezzlement from an employee benefit plan and one count of failure to file an annual report. He made his initial appearance today before U.S. Magistrate Judge Michael A. Hammer in Newark federal court and was released on $100,000 unsecured bond.

Continue reading Teaneck Man Charged With Embezzlement from Employee Benefit Plan

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Bergen County,Man Admits Bribing State Department Employee

the staff of the Ridgewood blog

Teaneck NJ,  A Bergen County, man today admitted giving a bribe to an employee of the U.S. Department of State, U.S. Attorney Craig Carpenito announced.

Luis Santos, 37, of Teaneck, New Jersey, pleaded guilty before U.S. District Judge Michael A. Shipp in Trenton federal court to an information charging him with one count of bribery of a public official.

Continue reading Bergen County,Man Admits Bribing State Department Employee

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Ridgewood Teachers 8th Highest Paid in Bergen County and 31st Highest Paid in the Garden State

photo courtesy of the NEA

the staff of the Ridgewood blog

Ridgewood NJ, The state Department of Education recently released its annual Taxpayer’s Guide to Education Spending for 2018, which shows the median salary in every New Jersey school district and charter school.

Continue reading Ridgewood Teachers 8th Highest Paid in Bergen County and 31st Highest Paid in the Garden State

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NJ TRANSIT BUS ROUTES FROM RIDGEWOOD TO DETOUR AS ROUTE 495 LANE CLOSURES SET TO BEGIN

Ridgewood-bus_terminal_theridgewoodblog

August 1,2018

the staff of the Ridgewood blog

Ridgewood NJ,  To accommodate the lane closures necessary as part of the New Jersey Department of Transportation’s (NJDOT) rehabilitation of the Route 495 Bridge over Routes 1&9 and Paterson Plank Road in North Bergen, several NJ TRANSIT local bus routes will require detours.

The Exclusive Bus Lane (XBL) will be maintained weekday mornings (6 a.m. – 10 a.m.) throughout the construction.

Beginning Friday night, August 10, the 31st Street ramp from Kennedy Boulevard to Route 495 westbound will be closed with traffic detoured onto Paterson Plank Road, directly affecting NJ TRANSIT’s local service on 18 bus routes requiring detours in the afternoon and at night. A week later, on Friday, August 17, one lane of Route 495 in each direction will be closed, limiting the roadway capacity and causing severe congestion. The construction requiring detours is anticipated to last approximately two and a half years.

· Buses will operate their regular routing westbound along 31st Street through Union City the entire span of the day.

· All current Union City bus stops on 31st Street will be served, including both Bergenline Avenue and Kennedy Boulevard.

· Between 6 a.m. and 1 p.m. on weekdays, all NJ TRANSIT Buses using the 31st Street ramp will follow regular routes and continue to have access to Route 495 westbound.

· All buses between 1 p.m. and 6 a.m. the next morning will continue to use the 31st Street ramp but will be detoured onto Paterson Plank Road.

· Delays through Union City are anticipated due to increased traffic volume, and customers should plan accordingly for these delays.

Buses may encounter conditions that result in significant delays in the outbound direction during both the morning and evening peak periods.

AFFECTED BUS ROUTES

The following bus routes will be detoured between 1 p.m. and 6 a.m. daily during construction:

No. 87 Jersey City-Hoboken

No. 107 South Orange-New York

No. 108 Newark-New York

No. 111 New York-IKEA-Jersey Gardens

No. 124 Secaucus-New York

No. 127S Ridgefield-Union City-New York

No. 129 Secaucus-Union City-New York

No. 144 Elmwood Park-Hackensack-New York

No. 160 Elmwood Park-Wallington-New York

No. 161 Paterson-Passaic-New York

No. 163 Ridgewood-New York

No. 167 Harrington Park-Teaneck-New York

No. 190X Paterson-Rutherford-New York

No. 190 (local) Paterson-Rutherford-New York

No. 191 Willowbrook-Montclair-New York

No. 192 Clifton-New York

No. 195 Willowbrook-Cedar Grove-New York

No. 199 Clifton-Lyndhurst-New York

The following bus routes do not require a detour, but are expected to be impacted by delays due to increased traffic congestion:

No. 83 Hackensack-Jersey City-Journal Square

No. 85 Mill Creek-Harmon Meadow-Hoboken

No. 127 (regular) Ridgefield-Union City-New York

No. 320 Mill Creek-North Bergen Park & Ride-New York (a detour will be necessary in later stages and information will be provided in advance)

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Horizon Blue Cross Blue Shield of New Jersey Accused of Placing only Most Expensive Hospitals as OMNIA’s Tier 1 partners

Valley Hospital

July 26,2018

the staff of the Ridgewood blog

Ridgewood NJ according to Beckers Hospital review ,Horizon Blue Cross Blue Shield of New Jersey paid a consulting group $1.7 million to produce reports on how the health insurer could develop its OMNIA Health Plans, which place hospitals in two tiers based on quality and cost. Lower-ranked hospitals argue three reports from McKinsey & Co. obtained by NJ Advance Media show Horizon steered McKinsey’s research to include the state’s most expensive hospitals into Tier 1, according to NJ.com.

Valley Hospital sued Horizon Blue Cross Blue Shield after it was placed on the tier 2 list .

Becker’s Hospital Review previously reported 10 findings from McKinsey’s reports on June 28. Below are another five highlights from the analysis:

1. In Horizon’s first 2014 memo to McKinsey, the health insurer outlined OMNIA’s objectives: narrow down Tier 1 and 2 hospitals and lower the health insurer’s costs. Under OMNIA, if policyholders want the lowest out-of-pocket costs compared to other Horizon plans, they must visit one of the 36 hospitals in Tier 1 that agree to accept lower reimbursements from Horizon in exchange for more patients.

2. All major New Jersey health systems Horizon later designated as Tier 1 hospitals — Hackensack Meridian Health, Robert Wood Johnson University Health in New Brunswick, St. Barnabas Medical Center in Livingston and Atlantic Health System in Morristown — were absent from McKinsey’s initial top 14 hospitals, according to NJ.com’s analysis of the reports. The documents reveal Horizon CEO Kevin Conlin told McKinsey to downplay how much a hospital’s size and cost would affect which hospitals the firm chose for OMNIA’s Tier 1 partners. Horizon argued OMNIA’s value-based model meant “past financial performance is not necessarily indicative of future cost of care,” according to the report.

3. In addition, one of the reports from May 2014 highlights how OMNIA intended to steer patients away from hospitals in New York. McKinsey analyzed 2013 data to show how much Horizon paid physicians and hospitals in New York, and how much placing New York hospitals in Tier 2 would positively affect Tier 1 hospitals. For example, McKinsey projected Hackensack would see $25 million in profits “from volume in other hospital in service area,” as well as $8 million from other competitors like New York.

4. In a lawsuit, two Tier 2 hospitals — 451-bed Valley Hospital in Ridgewood, N.J., and 284-bed CentraState Medical Center in Freehold, N.J. — claim Horizon “breached its duty to act in good faith” by placing them in OMNIA’s Tier 2, thereby costing them millions of dollars. Holy Name Medical Center in Teaneck was also a plaintiff in the hospitals’ case until June 26, when it and Horizon announced they had reached a confidential settlement.

Full report from NJ.com

https://www.nj.com/politics/index.ssf/2018/07/here_are_the_documents_horizon_did_not_want_the_pu.html