Vicente Lopez
Attorney General Matthew J. Platkin, the Division of Criminal Justice (DCJ), and the Office of the Insurance Fraud Prosecutor (OIFP) announced today that an East Orange, New Jersey, man has been indicted for allegedly filing tens of thousands of false Medicaid claims and receiving over $3.4 million from the program through a company he took over from his deceased sister.
Vicente Lopez, 63, was indicted by a state grand jury on September 3, 2025, for health care claims fraud (2nd degree), theft by deception (2nd degree), Medicaid fraud (3rd degree), and three counts each of failure to pay tax and filing a fraudulent return (all 3rd degree).
“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.”
“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,” said DCJ Director Theresa L. Hilton. “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.”
“Insurance fraud – especially when it targets publicly funded programs – is a crime that victimizes all of us,” said Interim Insurance Fraud Prosecutor Al Garcia. “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 documents filed in this case, Lopez is the head of Joyce Lopez & Associates (JLA), which at one time provided psychological counseling services to Medicaid beneficiaries. After Joyce Lopez (Vicente Lopez’ sister) died in 2021, Vicente Lopez took sole control of JLA.
Lopez allegedly billed or directed his employees to bill Medicaid for psychological services (over 34,000 individual claims) and received approximately $3.4 million from Medicaid, despite that neither he, nor JLA as a company, were approved Medicaid providers. Lopez allegedly billed or directed his employees to bill under the provider name and number of a licensed psychiatrist, identified as “TF,” without that person’s permission or knowledge. TF did not provide psychotherapy services to a single patient at JLA. Lopez also allegedly billed Medicaid when a patient canceled an appointment or did not show up, and allegedly billed Medicaid for psychological services when JLA was only delivering case management services.
Additionally, Lopez failed to pay taxes for tax years 2021, 2022, and 2023. When brought to his attention by the State, Lopez eventually filed, but failed to disclose his full income. As of June 18, 2025, Lopez has a personal net New Jersey State tax liability of $52,372 for tax years 2021-2023. He also owes a combined civil fraud penalty to the State of New Jersey totaling $26,186, with an additional $21,151 in interest, totaling $99,709 in taxes, penalties, and interest.
This case is being prosecuted by OIFP – Medicaid Fraud Control Unit (MFCU) DAsG Laura L. Bryant and Simret Michael, under the supervision of Assistant Bureau Chief Michael Klein and Bureau Chief Heather Hadley. The case was investigated by Sergeant Michael Rosati, under the supervision of Lieutenant Joseph Jaruszewski, and Deputy Chief Rich King. Interim Insurance Fraud Prosecutor Garcia thanked the New Jersey Division of Taxation, Office of Criminal Investigations, for its assistance in the case.
The charges and allegations contained in the indictment are merely accusations, and the defendant is presumed innocent unless and until proven guilty in a court of law.
Second-degree charges carry a sentence of five to 10 years in state prison and a fine of up to $150,000.
Third-degree charges carry a sentence of three to five years in state prison and a fine of up to $15,000.
New Jersey MFCU’s total funding for federal fiscal year (FY) 2025 is $12.63 million. Of that total, 75 percent, or $9.47 million, is awarded under a grant from the U.S. Department of Health and Human Services. The remaining 25 percent, totaling $3.16 million for FY 2025, is funded by the State of New Jersey.
If you suspect Medicaid fraud or elder abuse and neglect, report it at Medicaid Fraud or Elder Abuse & Neglect Reporting Form, or by phone at (609) 292-1272, or via email at NJMFCU@njdcj.org.
