A New Jersey grand jury recently indicted a Wyckoff NJ cardiologist who allegedly defrauded multiple insurance companies.
According to prosecutors in the case, the suspect double-billed three insurance companies and ended up getting away with approximately $600,000 as a result of his fraud. The double-billing reportedly included sending fake bills to Horizon Blue Cross Blue Shield of New Jersey and UnitedHealthcare Inc.
The suspect is also accused of faking medical treatment bills that he sent to Horizon Blue Cross Blue Shield of New Jersey, United Healthcare Inc., and Aetna.
The double-billing reportedly occurred between December 2010 and August 2011, while the more general insurance fraud occurred between April 2006 and October 2011.
The details of the alleged fraud were as follows: the suspect filed insurance claims through his three medical practices in Paramus, New Jersey. However, the suspect allegedly filed claims for treating the same patient at each of the practices. When Horizon noticed that the suspect may have been committing insurance fraud, they notified the NJ Insurance Fraud Prosecutor’s Office. Detectives with the state agency then began an investigation into the suspect.
The suspect, a 69-year-old man who lives in Wyckoff, New Jersey, has been charged with nine counts of healthcare fraud, as well as multiple counts of insurance fraud and theft by deception.
Now the suspect is set to face trial after a state grand jury issued an indictment on all nine counts of healthcare fraud.
If the suspect is convicted on any of the second degree fraud charges, he could potentially be sentenced to 5-10 years in New Jersey State Prison. Additionally, a conviction could lead to the imposition of a $150,000 fine, as well as a requirement that the suspect pay restitution for the stolen funds.
For additional information about this case, read the NJ.com article, “N.J. Cardiologist Indicted for Cashing in $600K by Double-Billing.”