New Jersey Man Poses as Doctor in Medicaid Scheme
A New Jersey man has been charged with conspiracy to commit health care fraud after allegedly posing as a licensed physician and treating patients even though he had no medical license.
December 21, 2011
New Jersey Man Poses as Doctor in Medicaid SchemeA New Jersey man has been charged with conspiracy to commit health care fraud after allegedly posing as a licensed physician and treating patients even though he had no medical license.
The Atlantic Highlands Herald reported that the man, a resident of Hawthorne, N.J., has admitted to posing as a licensed physician. In this role, he prescribed medications and ordered medical procedures at a medical practice based in Elizabeth, N.J.
The defendant earned $10 an hour for this work, according to the story. The man has since pleaded guilty to one count of conspiracy to commit health care fraud, entering his plea in Newark federal court.
The case, though, reaches beyond this one individual. According to the Atlantic Highlands Herald, the man worked for a 47-year-old doctor who ran the practice. This doctor, along with his wife, earlier pleaded guilty to conspiracy to commit health care fraud, too. In doing so, he admitted to using unlicensed individuals to treat patients. This doctor also admitted to billing Medicaid and Medicare as if he himself provided these services.
The defendant who posed as a licensed physician told the court that he posted an ad on craigslist, making it clear, he says, that he was not licensed. The doctor who ran the clinic then contacted him and offered him a job. According to the FBI, more than 20,000 patient visits at the office were conducted by unlicensed individuals. These visits were all billed to Medicare or Medicaid as if the doctor who ran the clinic conducted them.
Not surprisingly, the doctor at the center of this case ranked as the top prescriber of drugs to Medicaid patients in New Jersey in 2009. During that year, he prescribed more than $9 million in Medicaid drugs. This easily outdistanced the doctor who finished in second place that year, a physician who prescribed less than $6 million in Medicaid drugs.
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