ANDREW POULOS VS. STATE OF NEW JERSEY (L-2263-18. MERCER COUNTY AND STATEWIDE)

New Jersey Superior Court Appellate Division·Decided August 23, 2021·No. A-4427-18·Unpublished

Opinion

NOT FOR PUBLICATION WITHOUT THE APPROVAL OF THE APPELLATE DIVISION This opinion shall not "constitute precedent or be binding upon any court ." Although it is posted on the internet, this opinion is binding only on the parties in the case and its use in other cases is limited. R. 1:36-3.

SUPERIOR COURT OF NEW JERSEY APPELLATE DIVISION

DOCKET NO. A-4427-18

ANDREW POULOS, Plaintiff-Appellant,

v.

STATE OF NEW JERSEY, OFFICE OF THE STATE COMPTROLLER, and JOSHUA LICHTBLAU,

Defendants-Respondents.

Argued November 16, 2020 – Decided August 23, 2021 Before Judges Messano, Hoffman, and Suter.

On appeal from the Superior Court of New Jersey, Law Division, Mercer County, Docket No. L-2263-18.

R. Armen McOmber argued the cause for appellant (McOmber & McOmber, PC, attorneys; R. Armen McOmber and Matthew A. Luber, of counsel and on the briefs).

Domenick Carmagnola argued the cause for respondents (Carmagnola & Ritardi, LLC, attorneys;

Domenick Carmagnola, of counsel and on the brief;

Stacy Landau, on the brief).

PER CURIAM This appeal is from an order dismissing plaintiff's amended complaint under the Conscientious Employee Protection Act (CEPA), N.J.S.A. 34:19-1 to -14. We reverse the May 24, 2019 order in part to permit discovery without prejudice to further motion practice. The standard of review for motions made under Rule 4:6-2(e) requires that the amended complaint be viewed liberally to determine if there is a fundament of a cause of action. Printing Mart-Morristown v. Sharp Elecs. Corp., 116 N.J. 739, 746 (1989). We conclude the amended complaint meets this standard in part.

I.

On October 30, 2018, plaintiff Andrew Poulos filed suit under CEPA against defendants, the State of New Jersey, Office of the State Comptroller (OSC) and Joshua Lichtblau (defendant), (collectively, defendants), who was the Director of the Medicaid Fraud Division (MFD)1 within the OSC at all

1 In 2010, the "functions, powers and duties" of the Office of the Medicaid Inspector General were transferred to the OSC, which then created the Medicaid Fraud Division. E.B. v. Div. of Med. Assistance & Health Servs., 431 N.J. Super. 183, 204 (App. Div. 2013). "The Medicaid Fraud Division conducts investigations of fraud, waste and abuse, performs background checks on all

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relevant times. Defendants' motion under Rule 4:6-2(e) was granted without prejudice in February 2019. Plaintiff filed an amended complaint against the same defendants on March 15, 2019, raising the same claims. We rely on the facts alleged by plaintiff in his amended complaint.

A.

Plaintiff was employed as a supervising investigator within the MFD of the OSC from November 2011 until his position was terminated on December 29, 2017. In February, the OSC commenced an investigation of Medicaid fraud in the Lakewood area. Known as "Operation Blue Claw" (the Operation), plaintiff claimed he was "the point person for the entire operation." He alleged he supervised the investigations, communicated with "partner agencies," and briefed the MFD director, its deputy director and its chief of investigations.

The Operation included an amnesty from prosecution component (amnesty program) that plaintiff "designed" in conjunction with the director, deputy director and chief of investigations. The amnesty program "permit[ted] individuals in receipt of [improperly received] Medicaid benefits to turn themselves in and pay back what they received without being criminally

Medicaid provider applicants, and coordinates oversight efforts among all State agencies that provide and administer Medicaid services and programs." Ibid., n.11.

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charged." Defendant obtained approval from the Comptroller for the amnesty program in January 2017.

Plaintiff claimed that a representative from the Ocean County Prosecutor's Office suggested it would be problematic for the State to grant amnesty for losses of more than $75,000 — the threshold for a second-degree crime. Therefore, on July 27, 2017, defendant wrote to the Comptroller advising that under the amnesty program, "the MFD would not seek full repayment of Medicaid benefits associated with the applicant's children so as to keep the amounts under $75,000, thereby reducing the chance the agreed upon amount would result in second-degree charges." Plaintiff's amended complaint does not state if a response was obtained.

In late November 2017, counsel for "numerous applicants" advised plaintiff that his clients needed more than six months "to pay back the full amount owed." Plaintiff met with defendant, the deputy director and chief of investigations, memorializing this discussion in a memorandum dated November 27, 2017. Defendant "was not willing" to ask the Comptroller to extend the time for repayments, because the amnesty program allowed six months for repayment.

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Plaintiff's amended complaint states that he initiated "the topic of negotiating the repayment amounts down to reasonable amounts so payment can be made in the time frame." The chief of investigations was "hesitant," and the deputy director thought it would be "problematic." Plaintiff countered that if individuals were prosecuted, they would have one to three years to pay restitution, and that this would be consistent with the purpose of the program by "reduc[ing] the MFD case load by bringing people into compliance without prosecution." Defendant apparently then "authorized [plaintiff] to negotiate the repayment amounts to address those with legitimate financial hardships." If that was not successful, defendant would then discuss with the Comptroller the issue of extending payment terms.

Plaintiff was contacted by the attorney for a party who already signed a settlement agreement, asking for a reduction in the repayment amount for his client. Plaintiff referred the attorney to defendant. "Upon information and belief," plaintiff alleges defendant spoke with the Comptroller about a reduction, but the Comptroller was not aware cases were settling at less than the full amount. Plaintiff claims defendant told the Comptroller that plaintiff was reducing the settlement amounts without MFD knowledge and defendant had not authorized this.

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On December 8, 2017, plaintiff was removed from handling the amnesty program. On December 11, 2017, plaintiff sent an email to the chief of investigations, with a copy to the chief of staff, stating he had the "impression" the Comptroller thought he had acted "unilaterally" in settling cases for a reduced amount, but that defendant knew about this. Plaintiff claimed his removal from the amnesty program indicated the Comptroller "has not been provided an accurate accounting of the operation of the program."

On December 13, 2017, plaintiff sent another email to the chief of investigations, with a copy to the chief of staff, reporting it was rumored he was terminated from his position. He alleged this damaged his reputation and compromised the MFD investigations.

On December 14, 2017, plaintiff was advised his position was discontinued effective December 29, 2017. He claims this was done in retaliation for his emails that contradicted the claim he unilaterally negotiated settlements under the amnesty program for less than the full amount.

Plaintiff's amended complaint claims he reported several issues about defendant to his superiors. He reported that defendant instructed plaintiff and others not to tell the Comptroller about deviations from the "directives" of the amnesty program. He claims it was a deviation from these directives to settle

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or renegotiate the cases for less than the full amount. Plaintiff reported that defendant denied knowledge of this and blamed plaintiff for these settlements. Plaintiff reported that defendant withheld "key details" from the Comptroller about the amnesty program and the Operation and "improperly" disclosed internal discussions that compromised the investigations.

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ANDREW POULOS VS. STATE OF NEW JERSEY (L-2263-18. MERCER COUNTY AND STATEWIDE), (N.J. Ct. App. 2021).

ANDREW POULOS VS. STATE OF NEW JERSEY (L-2263-18. MERCER COUNTY AND STATEWIDE) (ANDREW POULOS VS. STATE OF NEW JERSEY (L-2263-18. MERCER COUNTY AND STATEWIDE)) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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