TRENTON
- Attorney General Anne Milgram and Criminal
Justice Director Deborah L. Gramiccioni announced
that a Monmouth County dentist, his office
manager and his dental practice were charged
in an eleven-count state grand jury indictment
for fraudulent billing Medicaid and for making
patients responsible for loans for which they
did not apply.
According to Insurance Fraud
Prosecutor Greta Gooden Brown, Marc Weber,
43, of Red Bank, a licensed dentist, his office
manager, Jennifer Barbers, 39, of Manalapan,
and Weber’s dental practice, Whitehouse
Dental Office, P.A. (d/b/a Weber Dental Associates),
located on Broad Street in Red Bank, were
variously charged with second-degree conspiracy
and second-degree health care claims fraud,
as well as Medicaid fraud, theft by deception,
theft by unlawful taking, and theft of identity,
all in the third-degree. The indictment was
returned yesterday and filed in court today.
The indictment alleges that
between Jan. 1, 2004, and June 30, 2008, Weber
and Barbers, who are now married to each other,
stole more than $3,565 from Medicaid for services
that were never rendered and/or completed.
According to the indictment, Weber and Barbers
regularly instructed another employee who
handled the billing for the dental practice,
to submit claims to Medicaid for pre-approved
work prior to the completion of the pre-approved
work. Barbers instructed the same employee
to submit claims to Medicaid for a patient’s
entire treatment plan on the patient’s
first office visit, even if the patient did
not return to the office to complete the treatment.
She also allegedly instructed an employee
to bill Medicaid for crowns and dentures on
the patient’s initial visit rather than
when or if the work was completed.
According to the indictment, Barbers allegedly
convinced patients to take out loans for dental
procedures using specific loan providers,
even when the procedures were covered by insurance.
She then allegedly processed the loans without
the patients’ authorization, and collected
payments from the loan providers even if the
patients decided not to have the dental work
performed. As a result of Barbers’ alleged
actions, the patients were responsible for
paying back the loans. According to the indictment,
Barbers obtained the identifying information
of three patients from the loan applications
and assumed the identity of those patients
in order to obtain the proceeds of the loans.
It is alleged that Weber, Barbers and the
dental practice fraudulently collected almost
$30,000 from the proceeds of these loans.
Detectives Ralph Anilo and
Eric Barnes, Civil Investigators Megan Flanagan,
Douglas Graham and William Coleman, Analyst
Bethany Schussler, and Deputy Attorneys General
Linda A. Rinaldi and James Flanagan were assigned
to the investigation. Rinaldi and Flanagan
presented the case to the state grand jury.
Insurance Fraud Prosecutor thanked Captain
Stephen McCarthy of the Red Bank Police Department
for his assistance in this investigation.
“Abuse of the Medicaid
Program and insurance fraud by persons who
hold professional licenses are particularly
disturbing crimes,” said Prosecutor
Brown. “Not only do such Medicaid fraud
schemes involve theft of tax dollars, they
also represent a theft from a program designed
to assist persons who can not afford health
insurance or health care services.”
The indictment is merely an
accusation and the defendants are 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 prison and a fine
of $15,000. The crime of third-degree Medicaid
fraud carries a maximum sentence of three
years in prison and a fine of $10,000.
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.
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