|
TRENTON
- Attorney General Stuart Rabner and Criminal
Justice Director Gregory A. Paw, announced
that a Plainsboro dentist pleaded guilty
today to theft for fraudulently altering
the dates of dental services on insurance
claims in order to obtain insurance payments
to which he was not entitled.
According
to Insurance Fraud Prosecutor Greta Gooden
Brown, Gary Reba, 60, of Plainsboro, pleaded
guilty before Superior Court Judge Frederick
P. DeVesa in Middlesex County to an accusation
which charged him with third-degree theft
by deception and fourth-degree falsifying
records. At the time of the criminal conduct,
Reba, a dentist licensed in the State of
New Jersey, owned and operated two dental
practices, one on Livingston Avenue in New
Brunswick and a second on Plainsboro Road
in Plainsboro.
At
the guilty plea hearing, Reba admitted that
between December 27, 2001 and December 20,
2004, he stole insurance claims money. Specifically,
Reba admitted that he submitted claims to
insurance companies reflecting that he provided
dental services on certain dates when, in
fact, the services were not provided on
the dates indicated. By doing so, Reba admitted
that he avoided contractual date restrictions
in the dental insurance policies. An investigation
by the Office of Insurance Fraud Prosecutor
determined that if Reba had billed for the
dates he actually rendered the dental services,
the patients would not have had dental insurance
coverage or would have already exceeded
the limits of their dental insurance for
that given year.
Among the insurance companies that received
insurance claims from Reba with falsified
dates were Horizon Blue Cross/Blue Shield
of New Jersey, Prudential Insurance Company,
MetLife Insurance Company, and Aetna Insurance
Company.
Crimes
of the third degree carry sentences of up
to five years in state prison and a fine
of up to $15,000, while crimes of the fourth
degree carry sentences of up to 18 months
in state prison and a fine of up to $10,000.
Reba may also face civil insurance fraud
fines. This matter will be referred to the
Dental Board for any action they deem appropriate
regarding Reba’s dental license.
Reba
is scheduled to appear before Judge DeVesa
on June 22 to be sentenced.
State
Investigator Scott Naismyth, Civil Investigator
Gina Lemanowicz, and Deputy Attorney General
Norma R. Evans were assigned to the investigation
into this case. Evans represented the State
at the guilty plea hearing.
“When
health care providers commit fraud, it is
particularly disturbing, because the integrity
of the health insurance claims process depends
on the trustworthiness of the licensed professionals
involved, ” said Insurance Fraud Prosecutor
Brown.
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.
The
Office of 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.
#
# #
|
