A 64-year-old East Orange man was sentenced Wednesday to three years in New Jersey state prison after admitting he ran a Medicaid fraud scheme that pulled in roughly $3.48 million through more than 34,000 false claims for psychological services. Vicente Lopez pleaded guilty earlier this year to health care claims fraud, Medicaid fraud, and three counts of filing a fraudulent tax return.
According to Insider NJ, Attorney General Jennifer Davenport and the Office of the Insurance Fraud Prosecutor announced the sentencing, which came out of Essex County Superior Court. In addition to the prison term, Lopez was ordered to pay $95,000 in restitution to the state of New Jersey.
The scheme traced back to Joyce Lopez & Associates, a counseling practice that, per the New Jersey Office of the Attorney General, at one time provided psychological counseling services to Medicaid beneficiaries. Lopez took sole control of the office after his sister, Joyce Lopez, died in 2021, according to the New Jersey Office of the Attorney General.
A Stolen Identity Behind Thousands of Claims
Neither Lopez nor the practice was ever approved as a Medicaid provider in its own right, the same account notes. Instead, prosecutors say Lopez used a licensed psychiatrist's name and provider number without that psychiatrist's permission or knowledge, billing Medicaid for services that were never actually rendered.
Acting Insurance Fraud Prosecutor Bernard J. Cooney said Lopez submitted thousands of false claims for services he was not qualified or authorized to provide. Attorney General Davenport added that Medicaid is intended to support vulnerable residents, not provide personal profit through fraudulent billing.
The case was investigated by Sergeant Michael Rosati and prosecuted by Deputy Attorney General Laura L. Bryant of the Office of the Insurance Fraud Prosecutor's Medicaid Fraud Control Unit, the unit that, per the same account, protects Medicaid beneficiaries and the Medicaid program from fraud, waste and abuse.
A Separate Tax Bill Nearing Six Figures
Beyond the Medicaid charges, Lopez also failed to pay state taxes for tax years 2021 through 2023. As of June 18, 2025, Insider NJ reports, he carried a personal New Jersey state tax liability of $52,372 for those years, plus $26,186 in combined civil fraud penalties and $21,151 in interest — bringing his total owed in taxes, penalties and interest to $99,709.
New Jersey's Broader Medicaid Fraud Fight
The Lopez case lands amid a wider statewide push against Medicaid fraud. New Jersey investigators recovered approximately $30.8 million in Medicaid payments during fiscal year 2025, while the state's Office of the State Comptroller separately reported recovering roughly $132.5 million in overpayments or potential fraud that same year, according to New Jersey Monitor. The comptroller's office had recovered $119.2 million in fiscal year 2024 and $114.5 million in fiscal year 2023, the outlet reported.
Medicaid covers 1.8 million New Jersey residents and pays for nearly two-thirds of all nursing-home residents in the state, New Jersey Monitor noted, underscoring the scale of the program Lopez is accused of exploiting. Nationally, Medicaid Fraud Control Units reported $1.3 billion in criminal recoveries from convictions and $706 million in civil recoveries for fiscal year 2025, along with 674 civil settlements and judgments, according to the U.S. Department of Health and Human Services Office of Inspector General.
Other New Jersey matters have also involved mental-health billing. A 2023 audit by the New Jersey Office of the State Comptroller found that Sokkyun Yi, a Princeton mental-health-services provider, improperly billed Medicaid and was paid by the program, according to a report from the New Jersey Office of the State Comptroller. That matter was described as an audit finding rather than a criminal case like the one against Lopez, and the available record does not allow a direct comparison of dollar amounts or penalties between the two.
