NEWARK – New Jersey’s Office of the Insurance Fraud Prosecutor today charged eleven individuals, including three chiropractors, with various offenses for their alleged roles in two separate schemes which used “runners” to recruit patients to the chiropractors’ practices, Attorney General Paula Dow announced.
“These alleged schemes involved chiropractors recruiting runners and runners recruiting patients, all in the name of greed,” said Dow. “Such conduct corrupts the insurance system because it gives powerful financial incentives that can influence a doctor’s treatment decisions to maximize insurance billings.”
As charged in the complaints, the chiropractors used “runners” to identify and contact individuals who had recently been involved in motor vehicle accidents. The runners would then recruit those individuals to undergo chiropractic treatment. The chiropractors paid the runners money for recruiting patients to their practices. The recruitment of patients by the runners, and the subsequent treatment, enabled the chiropractors to file claims for payment from multiple insurance companies.
New Jersey law includes an “anti-running statute,” which imposes criminal penalties for acting as a runner or using, directing, or employing a runner. The statute defines a “runner” as a person who attempts to procure a patient or client at the direction of and for a health care professional or attorney in exchange for a pecuniary benefit, when the health care professional or attorney intends to assert a claim against an insured person or an insurance carrier for providing services to the patient or client. The anti-running statute carries a presumptive sentence of three to five years in state prison, as well as other penalties.
“Insurance fraud is a major reason why New Jersey’s insurance rates, especially auto insurance rates, are among the highest in the nation,” said Acting Insurance Fraud Prosecutor Chillemi. “The Office of the Insurance Fraud Prosecutor will vigorously investigate and prosecute those who use running schemes to defraud insurance companies, and in turn, insurance consumers, who often bear the cost of such fraud through increased premiums.”
Three Perth Amboy men are accused of being “runners” for Scott Greenberg, D.C., a New Brunswick chiropractor. According to Chillemi, Greenberg allegedly paid a total of over $130,000 to six runners to recruit numerous patients to his practice between February 2010 and the present. Based on the investigation to date, runners were paid approximately $500 to over $1500 per patient in this alleged scheme, and over fifty patients were recruited.
Greenberg was charged with conspiracy, money laundering, health care claims fraud, misconduct by a corporate official and criminal use of runners. Orlando Sanchez, 44; Jimmy A. Tovar, 35 and Andres D. Sanchez Munoz, 42, all of Perth Amboy, were charged with conspiracy, money laundering, health care claims fraud, and criminal use of runners.
In a separate alleged scheme, the owners of Chiropractic Centre of Elizabeth, Chiropractic Centre of Newark and Chiropractic Centre of Jersey City are accused of conspiring to use runners to recruit over 50 patients. According to Chillemi, Christopher Montana, D.C. and Fernando Barrese, D.C. were arrested on charges of conspiracy, financial facilitation of criminal activity (money laundering), filing false and fraudulent tax returns, commercial bribery and use of runners.
Alcindor Robin, 56, of Elizabeth, was charged with conspiracy, health care claims fraud and use of runners. The complaint alleges that Robin acted as a runner by soliciting patients to receive medical treatment from doctors who intended to file claims with insurance companies.
Both investigations remain ongoing, as do asset forfeiture efforts, officials said. The defendants are presumed innocent until proven guilty in a court of law.
Dow thanked the Perth Amboy Police Department under the command of Acting Chief of Police Benjamin Ruiz, the New Jersey Division of Taxation, the Federal Bureau of Investigation, Newark Division, under the direction of Special-Agent-in-Charge Michael Ward, and the United States Attorney’s Office for the District of New Jersey, under the direction of United States Attorney Paul J. Fishman.
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