An East Orange man who took over his late sister's counselling company and used it to bill Medicaid for psychological services that were never properly provided has been sentenced to three years in New Jersey state prison, the New Jersey Attorney General's Office has announced. Vicente Lopez, 64, filed or directed thousands of false Medicaid claims and received approximately $3.48 million in fraudulent payments from the programme, according to the Attorney General's Office and the Office of the Insurance Fraud Prosecutor (OIFP).
Source: New Jersey Office of the Attorney General
Lopez pleaded guilty in June 2026 before Superior Court Judge L. Grace Spencer to health care claims fraud, Medicaid fraud, and three counts of filing a fraudulent tax return. Judge Spencer imposed the three-year sentence on October 21, 2026, in Essex County, and also ordered Lopez to pay $95,000 in restitution to the state, the Attorney General's Office said.
How the scheme worked
According to documents filed in the case and statements made in court, Lopez was the head of Joyce Lopez & Associates (JLA), a company that at one time provided psychological counselling services to Medicaid patients. After his sister Joyce Lopez died in 2021, Vicente Lopez took sole control of JLA, the Attorney General's Office said.
From that position, Lopez submitted or caused to be submitted over 34,000 claims to Medicaid for psychological services, receiving approximately $3.48 million in connection with those claims — even though neither Lopez nor JLA was an approved Medicaid provider, prosecutors said.
The false claims were submitted using the name and provider number of a licensed psychiatrist without that psychiatrist's permission or knowledge, according to the Attorney General's Office. The psychiatrist did not provide psychotherapy services to any JLA patients. Lopez also impermissibly billed Medicaid for services not rendered, prosecutors said; earlier charging documents in the case described billing for appointments patients had cancelled or not shown up for, and billing for psychological services when JLA was only delivering case management services.
What officials said
“Medicaid is intended to provide critical health care to vulnerable New Jersey residents who need it, not to serve as a source of personal profit through fraudulent billing,” Attorney General Jennifer Davenport said. “Individuals and families in New Jersey count on this health care lifeline. This sentence demonstrates that those who exploit this vital program for their own financial gain will be held accountable.”
“For years, the defendant submitted or directed the submission of thousands of false claims for services he was neither qualified nor authorized to provide,” said Acting Insurance Fraud Prosecutor Bernard J. Cooney. “His scheme resulted in millions of dollars in improper Medicaid payments, and today's sentence holds him responsible for that conduct.”
The tax case that ran alongside the fraud
The sentencing also covered Lopez's taxes. He failed to pay taxes for tax years 2021, 2022 and 2023, the Attorney General's Office said. When the state brought it to his attention, he eventually filed his returns but failed to disclose his full income. As of June 18, 2025, Lopez had a personal net New Jersey state tax liability of $52,372 for 2021–2023, plus a combined civil fraud penalty of $26,186 and $21,151 in interest — $99,709 in taxes, penalties and interest in total, separate from the $95,000 restitution ordered at sentencing.
Background: who polices Medicaid fraud in New Jersey
The case was prosecuted by Deputy Attorney General Laura L. Bryant of OIFP's Medicaid Fraud Control Unit (MFCU) and investigated by Sergeant Michael Rosati, with assistance from the New Jersey Department of the Treasury's Office of Criminal Investigation, the Attorney General's Office said. Lopez's defence counsel was Lisa Sullivan Lopata, an Assistant Deputy Public Defender. The MFCU is the unit that protects Medicaid beneficiaries and the Medicaid programme from fraud, waste and abuse; its total funding for federal fiscal year 2026 is $11.6 million, of which 75 percent comes from a grant from the U.S. Department of Health and Human Services and 25 percent from the State of New Jersey.
The Attorney General's Office asks anyone with information about Medicaid fraud, abuse or neglect to email NJMFCU@njdcj.org or call 609-292-1272. Insurance fraud can also be reported anonymously on 1-877-55-FRAUD or at NJInsuranceFraud.org; state regulations allow a reward for eligible information that leads to an arrest, prosecution and conviction.
Why this matters beyond East Orange
East Orange sits in Essex County, in the heart of one of the largest South Asian diaspora regions in the United States — New Jersey is home to large Punjabi communities in places such as Edison, Jersey City and Iselin, and many newcomer and elderly family members depend on Medicaid and other public health programmes for care they could not otherwise afford. Fraud on this scale does not just take money from the state: every false claim is paid out of the same pool that funds real counselling and care for low-income patients, which is why state prosecutors treat provider billing fraud as a direct attack on the programme's beneficiaries.
What happens next
With sentencing complete, Lopez begins a three-year state prison term and owes the $95,000 in restitution ordered by Judge Spencer, on top of the $99,709 tax liability recorded in the case. The Attorney General's announcement did not set any further court date in the case. The MFCU continues to investigate and prosecute Medicaid provider fraud across New Jersey, and officials used the sentencing to repeat their appeal for tips from patients, employees and family members who see billing for services that never happened.