New Jersey Chiropractor Sentenced in $89K Insurance Fraud

December 22, 2013

A northern New Jersey chiropractor was sentenced to state prison for causing false documentation to be submitted to insurance companies and subsequently receiving over $89,000 to which he was not entitled.

Joseph Salomone, 45, of Nutley, N.J., was sentenced last Thursday to four years in state prison by Hudson County Superior Court Judge Galis-Menendez. The sentence was based on the defendant’s guilty plea to second-degree health care claims fraud.

Salomone’s chiropractic license will also be suspended for a period of three years with an additional two years of probation. He has paid back the $89,283 as well as $75,000 in civil fines levied by the New Jersey Department of Banking and Insurance.

In pleading guilty last month, Salomone admitted that he directed his office workers to complete periodic re-evaluation forms which purported to list the results of range of motion tests on auto accident victims. The forms were supposed to be assessments by the chiropractor to see whether the patient needed to have continued, or perhaps different, chiropractic care.

An investigation by the state’s Office of the Insurance Fraud Prosecutor determined that Salomone directed his staff to complete the re-evaluation forms using pre-determined information unrelated to an actual assessment of the patient.

Accordingly, the patients’ medical records did not accurately reflect whether these patients actually needed to continue chiropractic care with Salomone, or perhaps needed a change in their treatment plan. As a result, Salomone received $89,283 in payments from insurance companies to which he was not entitled, authorities said.

An investigation determined that Salomone directed his office staff to submit the fraudulent documentation to the insurance companies — Allstate Insurance Company, High Point Insurance Company, Liberty Mutual Insurance Company, New Jersey Manufacturer’s Insurance Company and United States Automobile Association — as part of the billing process.

Source: New Jersey Attorney General’s Office

 

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