TRENTON
– Attorney General Paula T. Dow announced
today that an Essex County pain management
center and its owner have agreed to pay
$88,517 to resolve a State lawsuit that
accused the defendants of performing chiropractic
services on patients despite not being authorized
to do so, then billing insurance companies
for those services.
The State’s original
lawsuit against the Newark Pain Management
& Rehabilitation Center and its owner-president,
Daniel Enemuo, of Lake Hopatcong, was filed
in Superior Court by attorneys for the Division
of Law on behalf of the New Jersey Office
of the Insurance Fraud Prosecutor (OIFP)
in April 2009.
According to Acting Insurance
Fraud Prosecutor Riza Dagli, neither Newark
Pain Management nor Enemuo were authorized
to provide chiropractic services to patients,
but did so anyway from approximately July
2003 through November 2004. New Jersey law
prohibits corporations from providing chiropractic
services to patients if the corporation
is owned by unlicensed individuals.
Under terms of the settlement,
both Newark Pain Management and Enemuo have
admitted to causing false and/or misleading
claims to be provided to insurance companies
by failing to disclose that Newark Pain
Management was unauthorized to provide chiropractic
services. They also have admitted to violating
the New Jersey Insurance Fraud Prevention
Act.
The defendants’ settlement
payment includes a $75,000 civil penalty,
$7,347 in reimbursement of the State’s
attorneys’ fees and $6,170 in restitution
to State Farm Insurance.
“New Jersey’s
regulatory requirements are an important
component of ensuring patient safety and
must be followed,” said Acting Insurance
Fraud Prosecutor Dagli.
As part of the same OIFP
lawsuit, the State previously settled with
a third defendant, Dr. Delores Ensley of
Newark. Ensley paid a $10,000 civil penalty
in 2009 and admitted that she treated patients
for three months at Newark Pain Management
after her chiropractic license had expired,
thereby causing claims to be submitted to
insurance carriers. She also admitted violating
the New Jersey Insurance Fraud Prevention
Act.
Supervising Civil Investigator
Craig Leshner was assigned to investigate
the case. Deputy Attorney General Brian
Brennan of the Division of Law’s Banking,
Insurance and Insurance Fraud Section represented
the State in the lawsuit.
The case was referred to
the OIFP by State Farm Insurance. Acting
Insurance Fraud Prosecutor Dagli thanked
State Farm for its assistance in this matter.
The
Office of the Insurance Prosecutor was
established by the Automobile Insurance
Cost Reduction Act of 1998. The OIFP is
the centralized State agency that investigates
and prosecutes both civil and criminal insurance
fraud.
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