| TRENTON
- Attorney General Zulima V. Farber and
Division of Criminal Justice Director Gregory
A. Paw announced that an Essex County chiropractor
has been charged with conspiracy and health
care claims fraud in a $19,000 automobile
insurance PIP fraud.
According to Greta Gooden Brown, Insurance
Fraud Prosecutor, Eugene Williams, also
known as Carroll E. Williams, 69, last known
address is in Newark, was charged with conspiracy
and Health Care Claims Fraud, both in the
second degree. Under State law, crimes of
the second degree carry a maximum punishment
of 10 years in state prison and a criminal
fine of $150,000. In addition, Williams
faces civil insurance fraud fines. This
matter will be referred to the Chiropractic
Board for action it deems appropriate with
regard to his chiropractic license.
The Aug. 21 Essex County grand jury indictment
alleges that between Feb. 10, 2000 and Sept.
5, 2001, Williams, a licensed chiropractic
physician who worked at LaGuardia Primary
Health Care Center in East Orange, conspired
with others to cause bills to be submitted
to Parkway Insurance Company for chiropractic
and other services not rendered. An undercover
investigation determined that Williams billed
Parkway for services not provided to undercover
investigators and in one instance directed
an undercover investigator sit for a while
and leave without being treated. Williams
would then have bills submitted to Parkway
Insurance Company on behalf of the purported
patients. As a result, Parkway was fraudulently
billed more than $19,000 of those PIP insurance
bills.
Dr. LeClerc Addison, the former owner of
LaGuardia Primary Health Care, previously
plead guilty to health care claims fraud
and criminal use of runners and was sentenced
on April 19, 2005 to five years probation
conditioned on serving 364 days in the county
jail as part of the Office of the Insurance
Fraud Prosecutor’s investigation of
Personal Injury Protection (PIP) fraud.
State Investigator Anthony Abarno, Luis
Cruz, and Keith Johnson, and Deputy Attorney
General Andrew C. Fried were assigned to
the investigation into this case. DAG Fried
represented the State before the Essex County
Grand Jury. The Newark Police Department
assisted with the investigation.
“Our
office is committed to protecting New Jersey’s
citizens from unscrupulous acts by combating
insurance fraud in whatever form it takes.
Those who submit false health care claims
violate the laws of the State and the trust
of the public, and they do so at a significant
expense to people who play by the rules,”
said Insurance Fraud Prosecutor Brown. “As
it has in the past, the Office of the Insurance
Fraud Prosecutor will vigorously investigate
and prosecute this type of activity.”
The indictment, which was handed up Aug.
21, is merely an accusation. The defendant
is presumed to be innocent unless and until
proven guilty beyond a reasonable doubt.
Prosecutor Brown noted that some important
cases have begun with anonymous tips from
the public. People who are concerned about
insurance cheating and have any information
about a fraud can report it anonymously
by calling the toll-free hotline at 1-877-55-FRAUD,
or visiting the Web at 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.
The Office of the Insurance Fraud Prosecutor
was established by the Automobile Insurance
Cost Reduction Act of 1998. The Office is
the centralized state agency that investigates
and prosecutes both civil and criminal insurance
fraud, as well as Medicaid fraud.
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