According to Insurance Fraud
Prosecutor Greta Gooden Brown, Juan Carlos
Fischberg, 59, whose last known address
is in New York City, pleaded guilty before
Superior Court Judge Patricia Del Bueno
Cleary in Monmouth County to second-degree
health claims fraud. The charge was contained
in an Oct. 11, 2006 state grand jury indictment.
At the guilty plea hearing,
Fischberg, the former owner and operator
of Hudson Rehabilitation and Medical Center
in West New York, admitted that he billed
for electro-diagnostic services, including
nerve conduction velocity tests, that had
not been completed. Nerve conduction velocity
tests are sometimes used to diagnose injuries
to patients as the result of automobile
accidents. Most of the claims submitted
by Fischberg were submitted to automobile
insurance companies.
In total, the OIFP investigators
seized and reviewed patient records for
more than 5,000 Fischberg patients and determined
that Fischberg falsified nerve conduction
study results for his patients. As part
of the investigation, the Office of the
Insurance Fraud Prosecutor seized Fischberg’s
office building located in Jersey City and
sold it for approximately $452,000. That
money, and an additional approximately $64,000
in funds contained in several bank accounts,
were forfeited to the state.
The Office of the Insurance
Fraud Prosecutor filed a civil complaint
for injunctive relief in both New Jersey
and Delaware courts to stop Fischberg from
transferring any money from a family trust
in order to obtain restitution for the insurance
companies allegedly victimized by Fischberg’s
fraudulent billing.
As the result of these efforts,
it is anticipated that the state and the
insurance companies will realize in excess
of $2.5 million in restitution for insurance
companies, including the money forfeited
to the state for the Jersey City building,
and $50,000 in civil insurance fraud fines.
State Investigators Laura
Parisi and Robyn Greene, Civil Investigator
Chris Gasbarro, and Deputy Attorneys General
Cheryl Maccaroni, Steven Farman and Stephen
Cirillo were assigned to the investigation.
They received extensive assistance from
the OIFP Analytical Support Unit, and from
the attorneys in the Division of Law who
prosecute medical licensing cases. Maccaroni
represented the Office of Insurance Fraud
Prosecutor at the guilty plea hearing.
“When doctors commit
fraud it is particularly disturbing, because
the integrity of the health care claims
process depends on the trustworthiness of
the licensed professionals involved,”
Insurance Fraud Prosecutor Brown said. “The
Office of Insurance Fraud Prosecutor will
continue to vigorously investigate and prosecute
this type of criminal activity.”
Fischberg is scheduled to
appear before Judge Cleary on Aug. 10 to
be sentenced. Second-degree crimes carry
sentences of up to 10 years in state prison,
and a criminal fine of up to $150,000. The
defendant will also face civil insurance
fraud fines. Fischberg voluntarily surrendered
his New Jersey medical license in January
2004.
Prosecutor Brown noted that
some important cases have started with anonymous
tips. People who are concerned about insurance
cheating and have information about a fraud
can report it anonymously by calling the
toll-free hotline 1-877-55-FRAUD
or visiting the Web site www.NJInsuranceFraud.org.
State regulations permit an award to be
paid to an eligible person who provides
information that leads to an arrest, prosecution
and conviction for insurance fraud.
