View this article online: https://www.insurancejournal.com/news/east/2015/06/08/370859.htm
Four people in New Jersey including husband-and-wife chiropractors have been charged with operating a scheme to refer patients to each other to maximize insurance payouts and then hiding the practice by submitting fraudulent claims.
Passaic County, New Jersey, prosecutor Camelia Valdes on June 4 announced the arrests of Kenneth Gross, wife Michelle Dubnoff, orthopedist James Morales and Hasbrouck Heights, New Jersey, resident James Hill.
Gross ran a practice in Passaic, and Dubnoff and Morales had practices located in Toms River, New Jersey. They’re alleged to have referred patients to each other and submitted billing records that hid the fact that their practices were connected financially or through family ties, in violation of state law.
Hill acted as a runner to refer patients to Gross, who paid him off the books, prosecutors said. Hill is charged with failing to pay state taxes on that income.
Gross, of Morganville, and Morales, of Toms River, face charges including health claims fraud, conspiracy and commercial bribery. Hill faces similar charges in addition to tax and money laundering charges. Dubnoff is charged with conspiracy. The health claims fraud and conspiracy charges have maximum prison sentences of 10 years upon conviction.
Gross’ attorney, Jeffrey Simms, said all four defendants pleaded not guilty at an arraignment in municipal court on June 4. He said his client was a “capable, competent, professional medical proprietor, and he did what he thought was appropriate.”
“I think he can substantiate all of his financial records,” Simms said.
Morales couldn’t be reached at his office on June 4, and Dubnoff didn’t return a phone message left at her office. Her attorney, Henry Klingeman, declined to comment on the case. Hill’s lawyer, Michael Koribanics, said in an email he’s “investigating the allegations, and that is all they are, against him.”