TRENTON
- Criminal Justice Director Vaughn L.
McKoy announced that the Division of Criminal
Justice - Office of Insurance Fraud Prosecutor
has obtained an indictment charging a
Morris County resident whose New York
medical license had been revoked, with
theft for his role in an insurance fraud
scam.
According to Insurance Fraud Prosecutor
Greta Gooden Brown, Craig W. Gordon, 48,
River Edge Drive, Chatham, Morris County,
was charged with Health Care Claims Fraud
(2nd degree), theft by deception and practice
of medicine by unlicenced person (both
3rd degree). If convicted on all counts,
Gordon faces up to 20 years in state prison
and a criminal fine of up to $180,000.
In addition, Gordon faces civil insurance
fraud fines.
The Morris County Grand Jury indictment
alleges that between Jan. 26, 2000 and
Jan. 18, 2001, Gordon, a former doctor
whose State of New York medical license
was revoked in 1995, operated a business
known as GFM Health Services out of his
residence. It is charged that Gordon referred
to himself as “Dr. Gordon”
while taking patients’ pulses and
blood pressures. According to the indictment,
Gordon caused claims to be submitted to
Horizon Blue Cross/Blue Shield of New
Jersey (HBCBSNJ)through the Medicare program
for treatments to two patients for these
services. An investigation by the Division
of Criminal Justice - Office of Insurance
Fraud Prosecutor determined that the claims
created the false impression that health
care services had been provided by another
physician when, in fact, they were either
provided by Gordon, who is not a practitioner,
or not provided at all. It is charged
that as a result of the alleged scam,
HBCBSNJ paid out more than $10,900 in
claims.
State Investigator Robyn Greene, and Deputy
Attorney General Nicole D. Rizzolo were
assigned to the investigation. DAG Rizzolo
represented the Office of Insurance Fraud
Prosecutor before the Morris County Grand
Jury. This case was referred to the Office
of Insurance Fraud Prosecutor by HBCBSNJ.
The indictment, which was handed up on
Jan. 11, is merely an accusation. The
defendant is presumed to be innocent of
the charges unless and until proven guilty
beyond a reasonable doubt.
_ag-ph_update.gif)
