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Former Pilgrim administrator pleads guilty to stealing from insurance plan

Former Pilgrim administrator pleads guilty to stealing from insurance plan

An administrator at the Pilgrim Psychiatric Centre in Brentwood pleaded responsible Monday to thieving more than $132,000 from taxpayers by submitting hundreds of wrong claims to the overall health coverage company for state workers under his wife’s title for solutions that were being under no circumstances delivered, officials mentioned.

Joseph Gottesman, 43, of Dix Hills, a accredited psychologist and former affiliate director of functions at Pilgrim, pleaded responsible to a one count of next-degree grand larceny, in accordance to a information release from the point out inspector general’s business office. As component of a plea agreement, Gottesman paid out $132,514 in restitution to UnitedHealthcare and ought to comprehensive 420 hrs of community provider.

Gottesman, who had been suspended without the need of pay back from his career given that November 2020 with the New York Point out Office environment of Psychological Wellness, will also acquire a 12 months probation and have to resign. 2nd-diploma grand larceny is punishable by up to 15 years in prison.

“This individual’s plan to steal from taxpayers has last but not least caught up with him and he will no more time be used by New York Point out,” state Inspector Normal Letizia Tagliafierroin reported in a statement. “The suspicious amount of claims submitted had been flagged via the vigilance of the insurer and healthcare companies and then offered to my workplace.”

Gottesman’s attorney, Alexander Bateman Jr. of Uniondale, reported in a statement that his consumer “right away admitted what he had done” when contacted by investigators. Bateman attributed Gottesman’s steps to the worry of his wife battling a long-phrase health issues.

“Joe is a great person, a fully commited husband and loving father who manufactured a horrible slip-up which he’s having obligation for and dealing with it head on,” reported Bateman, incorporating: “That anxiety, stress and uncertainty, such as not recognizing if she would get far better, led Joe to do anything which was absolutely opposite to who he is and how he has or else led his daily life. He submitted claims to their insurance provider which were not accurate and as a final result obtained reimbursement which he should not have acquired. Joe has had remorse and regret about what he did, from the get started.”

The inspector general’s investigation identified Gottesman fabricated 448 claims for his spouse between Could 2016 and May perhaps 2019, the information launch mentioned, introducing that Gottesman stole the identifies of at minimum 6 out-of-network healthcare providers. The reimbursement checks had been sent right to Gottesman, with most of the cash deposited into the couple’s joint checking account, officers mentioned, and Gottesman cast his wife’s title to funds a lot of of the checks.

Gottesman submitted bogus promises for services for his spouse when she was actually out of city, such as in Florida and on family vacation in Aruba, officials reported. Investigators established that by analyzing the wife’s Fb web page as well as credit rating card buys, officers said.

The Suffolk County District Attorney’s Workplace assisted with the investigation and prosecuted Gottesman.

“This is a wonderful consequence for taxpayers that guarantees whole reimbursement of these stolen public money,” District Attorney Timothy Sini mentioned in a assertion.

The condition Health Insurance policies Method is administered by the state Section of Civil Service and addresses energetic and retired state workers, as perfectly as collaborating nearby authorities and faculty district employees.