An East Orange resident has been indicted for allegedly submitting thousands of false Medicaid claims and receiving more than $3.4 million from the program through a company he took over after his sister’s death, according to an announcement by Attorney General Matthew J. Platkin, the Division of Criminal Justice (DCJ), and the Office of the Insurance Fraud Prosecutor (OIFP).
Vicente Lopez, 63, was indicted by a state grand jury on September 3, 2025. The charges include health care claims fraud and theft by deception, both second-degree offenses; Medicaid fraud; and three counts each of failure to pay tax and filing a fraudulent return.
“Medicaid is a vital lifeline, providing needed health care coverage to low-income individuals and families,” said Attorney General Platkin. “Health care is expensive, and resources are finite, so it is especially troubling whenever someone chooses to steal from this important public program. This defendant is charged with defrauding the system of millions of dollars to which he was in no way entitled.”
DCJ Director Theresa L. Hilton stated: “Not only is the defendant charged with brazenly submitting 34,000 claims for services never provided, he also allegedly hid his income and failed to pay taxes. The indictment alleges that Lopez is neither qualified nor authorized to provide the services for which he was reimbursed by Medicaid. The charges we are announcing today will hold him accountable.”
Interim Insurance Fraud Prosecutor Al Garcia commented: “Insurance fraud – especially when it targets publicly funded programs – is a crime that victimizes all of us. It diverts limited public money from the people for whom it is intended. This kind of criminal activity will not be tolerated by my office.”
According to court documents, Lopez became head of Joyce Lopez & Associates (JLA), a company previously offering psychological counseling services to Medicaid beneficiaries, after his sister Joyce Lopez died in 2021. Authorities allege that Lopez or his employees billed Medicaid for over 34,000 psychological service claims using the provider name and number of a licensed psychiatrist without permission or knowledge from that provider. The psychiatrist did not provide any psychotherapy services at JLA.
Lopez also allegedly billed Medicaid when patients canceled appointments or did not show up and submitted claims for psychological services when only case management was provided.
In addition to these allegations, authorities say Lopez failed to pay state taxes for 2021 through 2023. When notified by state officials, he filed returns but did not disclose his full income. As of June 18, 2025, Lopez owes New Jersey $52,372 in personal state tax liability for those years along with civil fraud penalties and interest totaling $99,709.
The prosecution team includes members from OIFP’s Medicaid Fraud Control Unit under supervision from Assistant Bureau Chief Michael Klein and Bureau Chief Heather Hadley. The investigation involved Sergeant Michael Rosati and others under Lieutenant Joseph Jaruszewski’s oversight.
Second-degree charges could result in five to ten years in prison with fines up to $150,000; third-degree charges carry three to five years’ imprisonment with fines up to $15,000.
The New Jersey Medicaid Fraud Control Unit receives funding jointly from federal sources—primarily through grants from the U.S. Department of Health and Human Services—and state funds.
Authorities remind residents that anyone suspecting Medicaid fraud or elder abuse can report it via phone at (609) 292-1272 or email.
