N.J. Chiropractor Pleads Guilty In $89K Fraud - Insurance News | InsuranceNewsNet

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November 4, 2013 Property and Casualty News
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N.J. Chiropractor Pleads Guilty In $89K Fraud

TRENTON– Acting Attorney General John J. Hoffman announced that a northern New Jersey chiropractor pleaded guilty today to causing false documentation to be submitted to insurance companies and subsequently receiving more than $89,000 to which he was not entitled.

Joseph Salomone, 45, of Nutley, pleaded guilty to second-degree health care claims fraud before Superior Court Judge Mitzy Galis-Menendez in HudsonCounty.  The charge was contained in a July 27, 2012state grand jury indictment.

Judge Galis-Menendez scheduled sentencing for Dec. 19, 2013.  Under the plea agreement, the state will recommend that Salomone be sentenced to four years in state prison.  Salomone agreed to pay back over $89,000 in restitution to insurance companies for monies he fraudulently obtained.

In pleading guilty, Salomone admitted that he directed his office workers to complete periodic re-evaluation forms which purported to list the results of range of motion tests on automobile accident victims.  The forms were supposed to be assessments by the chiropractor to see whether the patient needed to have continued (or perhaps different) chiropractic care.  An investigation by the Office of the Insurance Fraud Prosecutor determined that Salomone directed his staff to complete the re-evaluation forms using pre-determined information unrelated to an actual assessment of the patient.  Accordingly, the patients’ medical records do not accurately reflect whether these patients actually needed to continue chiropractic care with Salomone, or perhaps, needed a change in their treatment plan.

"This defendant's criminal actions not only led to the illegal gain of more than $89,000, but also caused dozens of patients to receive unnecessary medical treatments," Acting Attorney General Hoffman said. "My office will aggressively investigate and prosecute corrupt chiropractors, especially when they use their patients as unwitting pawns in their unlawful schemes."

"Today's guilty plea reiterates the message that committing insurance fraud in New Jerseywill lead to a lengthy prison sentence," Acting Insurance Fraud Prosecutor Ronald Chillemi said.

An investigation determined that Salomone directed his office staff to submit the fraudulent documentation to the insurance companies – Allstate Insurance Company, High Point Insurance Company, Liberty Mutual Insurance Company, New Jersey Manufacturer’s Insurance Company and United States Automobile Association – as part of the billing process. 

Deputy Attorney General Reid Caster and Detective Scott Stevens were assigned to the case.  Acting Insurance Fraud Prosecutor Chillemi thanked Allstate Insurance Company, High Point Insurance Company, Liberty Mutual Insurance Company, New Jersey Manufacturer’s Insurance Company and United States Automobile Association for their assistance in the investigation.

 

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