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NJ's Largest Hospital System Ends In-Network Partnership With Horizon Over Price Disputes NJ's Largest Hospital System Ends In-Network Partnership With Horizon Over Price Disputes
NJ's Largest Hospital System Ends In-Network Partnership With Horizon Over Price Disputes Hackensack Meridian Health announced it is ending its in-network partnership with Horizon Blue Cross Blue Shield, effective June 1. A spokeswoman for Hackensack Meridian Health, New Jersey's largest not for profit healthcare organization, said they were unable to reach an agreement despite "lengthy negotiations."  "We have been and remain committed to reaching an agreement but must receive fair care reimbursements from Horizon to continue to invest in the care, medical technology, and locations that the local communities we serve rely on and expect," Jessica Cohen Nussman, public …

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by Sam Barron
News
USPS Worker Used Fake NJ Documents In $130K Welfare Fraud Scheme: DA USPS Worker Used Fake NJ Documents In $130K Welfare Fraud Scheme: DA
USPS Worker Used Fake NJ Documents In $130K Welfare Fraud Scheme: DA A Freeport woman and U.S. Postal Service employee is accused of defrauding public assistance programs of more than $130,000 by failing to report her income from two jobs and rental properties, Nassau County District Attorney Anne Donnelly announced Friday, Jan. 10. Angelique White, 32, allegedly received childcare and Medicaid benefits between 2017 and 2021 while omitting her income from the U.S. Postal Service, Northwell Health, and two rental properties she co-owned in Elmont and Freeport, according to Donnelly. White was arraigned Thursday before Judge Robert Pipia on charges of Grand La…

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by Jillian Pikora
News
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
News
Poor Conditions, Fraud: State Seizes Control Of 2 NJ Nursing Homes Poor Conditions, Fraud: State Seizes Control Of 2 NJ Nursing Homes
Poor Conditions, Fraud: State Seizes Control Of 2 NJ Nursing Homes A pair of South Jersey nursing homes, riddled with poor conditions and alleged Medicaid fraud, have been turned over to the control of an independent receiver, authorities said. The state Comptroller previously suspended the owners of Deptford Center for Rehabilitation and Healthcare and Hammonton Center for Rehabilitation and Healthcare from New Jersey Medicaid. A Superior Court judge ordered the appointment of Allen Wilen of the Eisner Advisory Group, LLC to run the nursing homes effective June 17, according to the New Jersey Comptroller's Office. The judge's appointment means that the r…

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by Jon Craig
Police & Fire
Disgraced Owner Of Failed NJ Nursing Home Chain From NY Admits Stiffing IRS Out Of $39M: Feds Disgraced Owner Of Failed NJ Nursing Home Chain From NY Admits Stiffing IRS Out Of $39M: Feds
Disgraced Owner Of Failed NJ Nursing Home Chain From NY Admits Stiffing IRS Out Of $39M: Feds 𝗨𝗣𝗗𝗔𝗧𝗘: A onetime insurance broker from Rockland County who ran a nationwide network of nearly 100 nursing homes into the ground from an office over a Bergen County pizzeria admitted that he purposely shorted the IRS nearly $39M, federal authorities said. Joseph Schwartz, 64, of Suffern, owned Skyline Management Group, which was based in the Wood-Ridge and amassed 95 nursing homes across 11 states. These once included Hudson View Care & Rehab Center in North Bergen, Brookhaven Health Care Center in East Orange and the Voorhees Care & Rehabilitation Center. Over a period of only sev…

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by Jerry DeMarco
Police & Fire
Phone Scammer From Atlantic City Who Preyed On Recently Widowed Seniors Pleads Out: US Attorney Phone Scammer From Atlantic City Who Preyed On Recently Widowed Seniors Pleads Out: US Attorney
Phone Scammer From Atlantic City Who Preyed On Recently Widowed Seniors Pleads Out: US Attorney A heartless public housing tenant from Atlantic City admitted that she scammed elderly victims out of more than $100,000 by claiming that they owed money on life insurance policies bought by a spouse who’d just recently died. Victoria Crosby, 46, was receiving Social Security and Medicaid benefits when she targeted the victims, all of whom were over 70 years old, U.S. Attorney Philip R. Sellinger said. Crosby called the seniors on a burner phone and, using phony names, claimed to be an employee of a retirement benefit office in some instances and a life insurance company in others, the U.S.…

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by Jerry DeMarco
News
'At End Of Our Rope:' NJ Son Seeks Help With Mom's Hellish Assisted Living Expenses 'At End Of Our Rope:' NJ Son Seeks Help With Mom's Hellish Assisted Living Expenses
'At End Of Our Rope:' NJ Son Seeks Help With Mom's Hellish Assisted Living Expenses It's everyone's nightmare, spiraling medical costs with no end in sight. Joseph Giamarese, of Princeton, is intimately familiar with the struggle. He's asking for help for his nearly 95-year-old mother whose been in need of steady intensive care the past 10 years. Marie Giamarese’s current level of care exceeds $15,000 per month. "For almost a decade, my mother has been in and out of physical rehabilitation, assisted living, and memory care facilities,"  Joseph Giamarese wrote on this GoFundMe page. After seven years of continuous decline, the constant need for care has taken its tol…

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by Jon Craig
News
Pediatric Dentist, Affiliates In NJ, NY Pay $750,000 For Unneeded Root Canals On Kids Pediatric Dentist, Affiliates In NJ, NY Pay $750,000 For Unneeded Root Canals On Kids
Pediatric Dentist, Affiliates In NJ, NY Pay $750,000 For Unneeded Root Canals On Kids A group of pediatric dentists in New Jersey and New York who were outed by a former worker for conducting medically unnecessary root canals on children agreed to pay more than $750,000 to settle charges against them, authorities in both states announced. Formerly known as HQRC Management Services LLC, the targeted practice was run by dentist Barry L. Jacobson, most recently of Alpine, NJ, they said. It included offices in Teaneck, Wyckoff, and Paterson in New Jersey and in the Bronx, Flushing, Valley Stream, Boro Park, Kingston, Monsey, Albany and Malone in New York. Jacobson and fellow de…

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by Jerry DeMarco
News
GUILTY: Fort Lee Doc With Clifton Practice Convicted Of Multi-Million-Dollar Medicare Fraud GUILTY: Fort Lee Doc With Clifton Practice Convicted Of Multi-Million-Dollar Medicare Fraud
Guilty: Fort Lee Doc With Clifton Practice Convicted Of Multi-Million-Dollar Medicare Fraud A rheumatologist from Fort Lee was convicted of billing Medicare and other health insurance programs for nearly a decade for services that patients never got and expensive medication that her Clifton practice never bought, federal authorities said. Alice Chu, 64, went to trial in U.S. District Court in Newark after federal authorities accused her of submitting more than $8.8 million in bogus claims for "items and services that were medically unnecessary, ineligible for reimbursement, and/or not provided as represented," court papers show. Jurors found her guilty on Tuesday, March 8 of consp…

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by Jerry DeMarco
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$100M In Medicaid Money Going To NJ's 15 Worst Nursing Homes: Report $100M In Medicaid Money Going To NJ's 15 Worst Nursing Homes: Report
$100M In Medicaid Money Going To NJ's 15 Worst Nursing Homes: Report Shape up or ship out. That's the message New Jersey's Comptroller is sending to 15 of the state's nursing homes, cited in a new report as some of the worst. New Jersey is spending $100 million a year in Medicaid dollars on some of the state's worst nursing homes. And the 15 "one-star" homes named in Comptroller's report released Wednesday have faced little to no consequences -- until now, the organization says. If the facilities don't fix the health and safety issues that they've repeatedly been cited for, they risk being kicked off Medicaid altogether. "Continued funding of these facilit…

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by Jon Craig
News
Cyber-Casanova From NJ Admits Duping Dozens Of Lonely Hearts Out Of $1.14M Cyber-Casanova From NJ Admits Duping Dozens Of Lonely Hearts Out Of $1.14M
Cyber-Casanova From NJ Admits Duping Dozens Of Lonely Hearts Out Of $1.14M A New Jersey man admitted that he orchestrated an online scam that conned dozens of unsuspecting women on dating sites out of more than a million dollars – and led one of them to suicide. Rubbin Sarpong, 37, of Millville pocketed the money and bought property in Ghana, along with luxury cars, expensive jewelry, top-shelf booze, designer clothes and more, federal authorities said. Then he flaunted it on Instagram. Sarpong had catfishing accomplices, several of whom live in Ghana, Acting U.S. Attorney for New Jersey Rachael Honig said. Posing as American military personnel stationed oversea…

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by Jerry DeMarco
News
Hudson Doctor's Employee Admits Role In $24.8M Kickback Scheme Hudson Doctor's Employee Admits Role In $24.8M Kickback Scheme
Hudson Doctor's Employee Admits Role In $24.8M Kickback Scheme UPDATE: Dominoes continued to fall in the federal takedown of a $24.8 million kickback scheme when a Jersey City woman who worked for a local doctor took a plea deal. Yudelka “Vicky” Ayala, 42, admitted conspiring with six co-defendants associated with the now-defunct Prime Aid Pharmacy in Union City to boost prescription sales through kickbacks and bribes to health care professionals in New Jersey and New York. Prime Aid, which also had a location in the Bronx, processed expensive medications used to treat various conditions, including Hepatitis C, Crohn’s disease, and rheumatoid arthritis…

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by Jerry DeMarco
News
Feds Charge Jersey Shore Pain Management Doc With Massive $24.6M Billing Fraud Feds Charge Jersey Shore Pain Management Doc With Massive $24.6M Billing Fraud
Feds Charge Jersey Shore Pain Management Doc With Massive $24.6M Billing Fraud A Jersey Shore pain management doctor accused of running a $24.6 million fraud scheme billed insurance plans for more than 24 hours worth of services in a single day no fewer than 900 times, federal authorities said Monday. Morris Antebi, 68, of Long Branch, also billed Medicare, Medicaid, and private insurance companies frequently on dates when travel records show he was overseas -- including trips to China, Israel, Turkey, the Dominican Republic and across Europe – and at other times when he was otherwise out of state, U.S. Attorney Craig Carpenito said. Antebi, who specializes in pain ma…

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by Jerry DeMarco
News
Supreme Court Chief Justice Joins Liberal Minority In Upholding Abortion Rights Supreme Court Chief Justice Joins Liberal Minority In Upholding Abortion Rights
Supreme Court Chief Justice Joins Liberal Minority In Upholding Abortion Rights For the first time since President Trump’s new appointees took their seats, the U.S. Supreme Court issued a pro-abortion decision on Monday. Chief Justice John Roberts, placing precedent over all else, joined the court's four minority liberals in striking down a Louisiana law that would have required doctors at abortion clinics to have hospital admitting privileges. The Louisiana Unsafe Abortion Protection Act, which never went into effect, required abortion doctors in the state to have admitting the privileges at hospitals within 30 miles of the clinics where they worked. The law was simi…

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by Jerry DeMarco