TRENTON
- Attorney General Jeffrey S. Chiesa announced
that a New York nutritionist was charged in
a state grand jury indictment today for allegedly
engaging in fraudulent billing to insurance
companies.
Azadeh
Ahmadi, 42, of New York City, was charged
with two counts of second-degree health
care claims fraud and two counts of third-degree
theft by deception.
The
state grand jury indictment alleges that
between May 2, 2005 and June 3, 2007, Ahmadi,
who has offices in Passaic and Ridgewood,
knowingly made false statements to Horizon
Blue Cross Blue Shield that nutrition counseling
services were provided to several patients
and that some of her patients suffered from
diabetes. It is alleged that the nutrition
counseling services were, in fact, not provided
and the patients did not suffer from diabetes
as claimed. The investigation by the Office
of the Insurance Fraud Prosecutor revealed
that Ahmadi allegedly received approximately
$18,111 from Horizon Blue Cross Blue Shield
to which she was not entitled. The indictment
also alleges that Ahmadi knowingly made
false statements to Aetna Insurance Company
that nutrition counseling services and tests
were provided to certain patients when,
in fact, the services and tests were not
provided. It is alleged that Ahmadi fraudulently
received approximately $22,133 from Aetna.
Deputy
Attorney General James A. Carey, Jr., Detective
Christine Sullivan and Civil Investigator
Lisa Yildiz were assigned to the investigation.
Carey presented the case to the state grand
jury. Acting Insurance Fraud Prosecutor
Ronald Chillemi thanked Jane Waller and
Timothy Dineen of Horizon Blue Cross Blue
Shield’s Special Investigative Unit
and Investigator Kim E. Lajoi of Aetna Insurance
Company for their assistance in the investigation.
He also thanked Horizon Blue Cross Blue
Shield for referring the matter to the Office
of the Insurance Fraud Prosecutor.
The
indictment is merely an accusation. The
defendant is presumed innocent until proven
guilty. Second-degree crimes carry a maximum
sentence of 10 years in state prison and
a criminal fine of $150,000, while third-degree
crimes carry a maximum sentence of five
years in state prison and a criminal fine
of $15,000. Ahmadi may also face civil insurance
fraud fines.
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