Medicaid Fraud Investigation Whistleblower Retaliated Against

A career investigator in the Medicaid Fraud Division (Division) alleges that he was made the scapegoat for the Lakewood Township “Amnesty Program,” which permitted dozens of welfare benefit recipients who had committed fraud to repay back only a small portion of what they received, despite officials in the State Comptroller’s Office promising that all of the defrauded benefits would be repaid in full.

In a whistleblower lawsuit filed by Andrew Poulos, he alleges that he was authorized by his superiors to negotiate settlements with welfare recipients for repayment of less than the full amount of the fraudulent benefits received. When the State Comptroller learned of the settlements, however, Mr. Poulos’ superiors claimed that they had no knowledge of the settlements, and that Mr. Poulos had unilaterally acted on his own without prior authorization or approval.

Worse yet, when Mr. Poulos notified his superiors that they were improperly withholding information from the State Comptroller about the details of the “Amnesty Program”, he was terminated from his position three days later.

Workplace Retaliation Is a Violation of State Law

Memoranda of meetings between Mr. Poulos and his superiors reveal that he brought the notion of such settlements to the attention of the Division’s Director, after being approached by a local Lakewood attorney asking if such settlements were possible. The memoranda further detail that in November of 2017, the Division’s Director authorized Mr. Poulos to arrange the settlements accordingly.

There is nothing in the memoranda to suggest that Mr. Poulos acted outside the scope of authorization given to him by the Director. When the State Comptroller questioned why the settlements were for less than 100 percent of what the recipients fraudulently received, Mr. Poulos was removed from his role in the investigation. He was subsequently terminated when he issued an email to his direct supervisor, the Chief Investigator, that the Director was not being truthful with the State Comptroller, concerning his authority to execute such settlements.

Prior to his termination, Mr. Poulos had been praised and applauded for his dedication to the investigation, and was awarded the State Comptroller’s Award of Excellence.

Matt A. Luber McOmber McOmber & Luber, P.C.. are part of the legal team representing Mr. Poulos. In a joint statement, the attorneys stated that “Mr. Poulos worked tirelessly to uncover and to put an end to Medicaid fraud within Lakewood’s Orthodox community.”

Then continued, “As alleged in the complaint, his unlawful termination is just another classic case of retaliation by New Jersey political operatives who, rather than face public scrutiny for their own decisions, terminated our client when he blew the whistle on an attempted cover-up. Mr. Poulos looks forward to exposing the lies, to setting the record straight, and to restoring his reputation. The complaint filed today is the first step in that process.”

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