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Healthcare fraud

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PA Lab Must Pay $7.3M To NJ After Charging $1,000 For $3 For Drug Tests: Comptroller PA Lab Must Pay $7.3M To NJ After Charging $1,000 For $3 For Drug Tests: Comptroller
PA Lab Must Pay $7.3M To NJ After Charging $1,000 For $3 For Drug Tests: Comptroller A Pennsylvania-based lab has been ordered to pay $7.3 to the state of New Jersey after overcharging New Jersey’s Medicaid program for urine drug testing services, officials said. Atlantic Diagnostic Laboratories (ADL) in Bensalem violated Medicaid regulations when it charged Medicaid as much as $1,035 per drug test while charging other payers as little as $2.38 for the same test, New Jersey's State Comptroller's office (OSC) said citing an audit report. Medicaid paid ADL between $63.40 and $180.40 for these same services. ADL also improperly billed for tests that the physician or …

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by Cecilia Levine
Police & Fire
Kickbacks Convinced Doc To Scam Medicare Out Of Nearly $21 Million: NJ Feds Kickbacks Convinced Doc To Scam Medicare Out Of Nearly $21 Million: NJ Feds
Kickbacks Convinced Doc To Scam Medicare Out Of Nearly $21 Million: NJ Feds A doctor pocketed cash kickbacks from lab companies and others for filing more than $20.7 million in bogus Medicare claims for medically unnecessary -- and often expensive -- COVID and cancer genetic tests, among other scams, a federal grand jury in Newark has charged. Alexander Baldonado, 68, of Queens already was awaiting trial dating back to charges brought a few years ago when grand jurors in Newark this week returned a superseding indictment that digs deeper into the allegations. Baldonado approved lab tests billed to Medicare in exchange for cash payoffs "from a laboratory representat…

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by Jerry DeMarco
Police & Fire
$70K Fraud Scheme Racks Up Charges For Hudson County Woman: Prosecutor $70K Fraud Scheme Racks Up Charges For Hudson County Woman: Prosecutor
$70K Fraud Scheme Racks Up Charges For Hudson County Woman: Prosecutor A 47-year-old Hudson County woman was arrested in a $70,000 healthcare fraud scheme, authorities said. Nicole Saunders, of Union City, failed to report income from a business she owns, resulting in an unlawful payment of more than $70,000 in medical benefits from NJ FamilyCare between 2017 and 2021, Hudson County Prosecutor Esther Suarez said. Saunders was arrested Tuesday, July 25, by members of the Hudson County Prosecutor’s Office Insurance Fraud Unit. She was charged with theft by deception and false reporting to Medicaid. Saunders was released on a summons pending her&n…

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by Cecilia Levine
Police & Fire
Passaic Woman Conspired To Obstruct Federal Investigation Into Fraudster Dentist Bros: Feds Passaic Woman Conspired To Obstruct Federal Investigation Into Fraudster Dentist Bros: Feds
Passaic Woman Conspired To Obstruct Federal Investigation Into Fraudster Dentist Bros: Feds A 26-year-old Passaic County woman was charged in a federal indictment with conspiring to obstruct a grand jury investigation into a pair of Pennsylvania brothers accused of running a multi-million criminal enterprise, authorities said. Susan Malpartida was named in the 42-count indictment against Bhaskar and Arun Savani, who were charged with racketeering, money laundering, healthcare fraud, and a litany of other felony offenses that could see them locked up for hundreds of years each if convicted, the Justice Department announced. A multi-year investigation into the brother…

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by Mac Bullock
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NJ Doc Took Bribes From Pharma Company For Toxic Fentanyl Prescriptions: Feds NJ Doc Took Bribes From Pharma Company For Toxic Fentanyl Prescriptions: Feds
NJ Doc Took Bribes From Pharma Company For Toxic Fentanyl Prescriptions: Feds A doctor from Central Jersey is accused of taking bribes and kickbacks in exchange for prescribing potentially fatal doses of fentanyl, authorities said. Mukaram Gazi, 51, of Marlboro in Monmouth County was charged with conspiracy to pay and receive kickbacks, receiving kickbacks, health care fraud and conspiring to unlawfully distribute dangerous narcotics, according to Acting U.S. Attorney Rachael A. Honig. According to Thursday's indictment: Gazi owned a urology practice with offices in Freehold, Hamilton, Howell and Toms River.  Gazi received more than $130,000 in bribes and…

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by Jon Craig
News
Authorities: Ring Got 30,000 Painkiller Pills With Prescription Blanks Swiped From NJ Hospitals Authorities: Ring Got 30,000 Painkiller Pills With Prescription Blanks Swiped From NJ Hospitals
Authorities: Ring Got 30,000 Painkiller Pills With Prescription Blanks Swiped From NJ Hospitals Using prescription blanks stolen from hospitals in Bergen and Passaic counties, a crew used a single pharmacy to get its hands on 30,000 high-dose oxycodone pills, including a year’s worth of painkillers prescribed to a dead man, authorities charged. The volume eventually gave them away, state and federal law enforcement officials said. Milagros Santiago, 43, of Haledon, was working as a pharmacy technician at St. Joseph’s Regional Medical Center in Paterson when she swiped prescription blanks, state Attorney General Gurbir S. Grewal said. The forged blanks were then filled at Panther Vall…

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by Jerry DeMarco
Police & Fire
Pharmacy Worker From Fort Lee Admits Role In Multi-Million-Dollar Health Care Fraud Pharmacy Worker From Fort Lee Admits Role In Multi-Million-Dollar Health Care Fraud
Pharmacy Worker From Fort Lee Admits Role In Multi-Million-Dollar Health Care Fraud A massive federal health fraud case claimed another conspirator when a Fair Lawn pharmacy employee from Fort Lee admitted participating in a scheme that cost a federal workers' compensation program millions of dollars. Zachary Ohebshalom, 34, was the second of five defendants to take a plea deal from federal prosecutors, less than a month after Estela Arco-Blaustein, 55, of Mahwah pleaded out in U.S. District Court in Newark for her role in the scheme. Still facing charges is Dr. Mark Filippone, 71, of Wallington. Their scheme to fill bogus prescriptions for medically unnecessary pain crea…

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by Jerry DeMarco
Police & Fire
Husband-Wife Owners Of Bayonne Telemedicine Company Indicted In $56M Medicare Fraud Husband-Wife Owners Of Bayonne Telemedicine Company Indicted In $56M Medicare Fraud
Husband-Wife Owners Of Bayonne Telemedicine Company Indicted In $56M Medicare Fraud A husband and wife who own two telemedicine companies with a location in Bayonne were indicted by a federal grand jury Wednesday for defrauding Medicare in a $56 million bribe and kickback scheme involving orthotic braces, authorities said. Reinaldo Wilson, 51, and Jean Wilson, 49, of Richmond Hill, Ga., are accused of using their companies to solicit kickbacks and bribes from patient recruiters, pharmacies and brace supplies – then hiring providers to order medically unnecessary braces for Medicare recipients, the U.S. Department of Justice said. Both were arrested Wednesday morning and la…

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by Jerry DeMarco
Police & Fire
Paramus Man Who Owned WNY Pharmacy Pleads Guilty To Fraud, Bribery Paramus Man Who Owned WNY Pharmacy Pleads Guilty To Fraud, Bribery
Paramus Man Who Owned WNY Pharmacy Pleads Guilty To Fraud, Bribery A Paramus man who owned a now-closed pharmacy in West New York admitted bribing a psychiatrist and defrauding public and private insurers in a scheme involving high-priced medications, the U.S. Attorney said Monday.  Eduard Shtindler, 36, carried out the bribery scheme for five years beginning in 2012. Schtindler, the owner of the shuttered Empire Pharmacy, sent employees to deliver the payments -- sometimes in the form of $100 bills stuffed into pill bottles -- to the Hudson County psychiatrist in exchange for steering patients to Empire.  Schintdler was heard on a recording refe…

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by Paul Milo
Police & Fire
East Orange Man Admits Role In Medical Insurance Fraud East Orange Man Admits Role In Medical Insurance Fraud
East Orange Man Admits Role In Medical Insurance Fraud An East Orange man said he worked with the owner of a medical billing company to submit false insurance claims for chiropractic services, the U.S. Attorney's Office said Friday.  Keasam Johnson, 35, pleaded guilty to conspiracy to commit healthcare fraud. He faces up to 10 years in prison and a $250,000 fine when he's sentenced in July.  Johnson worked as a supervisor at a telecoms firm when he submitted claims for out-of-network chiropractic services that were never performed. Authorities say Johnson and others who took part in the scheme received the cash instead with the help o…

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by Paul Milo