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For
Immediate Release: |
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For
Further Information Contact: |
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April
20, 2005
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Office
of The Attorney General
-
Peter C. Harvey,
Attorney General
Division
of Criminal Justice
- Vaughn L. McKoy, Director
Office of the Insurance Fraud
Prosecutor
- Greta Gooden Brown, Insurance
Fraud Prosecutor
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John
R. Hagerty
609-984-1936
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Essex
County Doctor and Niece Sentenced for Insurance
Fraud
Ordered
to Pay Fines and Restitution... Dr. to Surrender
Medical License...
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TRENTON
- Vaughn L. McKoy, Director, Division
of Criminal Justice, announced that an
Essex County doctor and his niece have
been ordered to pay more than $30,000
in restitution and fines after pleading
guilty to multiple counts of insurance
fraud, including submitting fraudulent
insurance claims for medical services
that were never provided to patients.
According to Insurance Fraud Prosecutor
Greta Gooden-Brown, Dr. LeClerc Adisson,
58, Walter Place, Irvington, Essex County,
and his niece, Lunic Adisson, 34, same
address, were sentenced by Essex County
Superior Court Judge Paul J. Vichness
on April 19. Judge Vichness sentenced
Dr. LeClerc Adisson to serve 364 days
in the Essex County Jail as a condition
of five years probation. Additionally,
Dr. Adisson was ordered to pay $26,000
in restitution to nine New Jersey insurance
companies, a $5,000 civil insurance fraud
fine, and to surrender his medical license.
Lunic Adisson was ordered to pay a $2,500
civil insurance fraud fine and to perform
50 hours of community service.
In pleading guilty on March 4 to a charge
of theft by deception, Dr. Adisson, the
former owner of Laguardia Primary Health
Care, 108 South Munn Ave., East Orange,
Dantor Medical Supply Co., and Clara Medical
Services, and Lunic Adisson (niece) admitted
that from April, 1997 through December,
2000, they improperly treated and referred
patients to the various Adisson-owned
facilities. As a result of those actions,
Adisson inflated claims for services and
medical supplies that were not prescribed
by treating chiropractic physicians and
then sought payment for services and supplies
that were not provided to patients.
The investigation determined that $48,273
in fraudulent bills were submitted to
the Zurich Insurance Group, Century Insurance
Company, New Jersey Manufacturers Insurance
Company, Progressive Insurance Company,
MDA Insurance Company, Liberty Mutual
Insurance Company, Keystone Insurance
Company, Prudential Insurance Company,
Clarendon Insurance Company, and State
Farm Insurance Company.
Insurance Fraud Prosecutor Gooden-Brown
noted that Dr. Adisson also pleaded guilty
to a separate criminal Accusation which
charged Health Care Claims Fraud and the
criminal use of “runners”.
The Accusation charged that from February,
2000 through September, 2001, Dr. Adisson
and another chiropractor (not named as
a defendant) submitted false auto insurance
Personal Injury Protection (PIP) claims
to Parkway Insurance. Adisson admitted
that he employed a “runner”
to procure additional patients in order
to beef-up the submission of insurance
claims. In using a “runner”
and in recklessly using the other chiropractor’s
false treatment notes, Adisson was able
to increase the amount of claims submitted
to insurance companies. Additionally,
Adisson admitting that referrals for MRI
services came from an outside medical
chiropractor and that he paid a “runner”
$100 for each MRI scan and $300 for every
patient referred to his practice by the
outside chiropractor for treatment. Parkway
Insurance Company was billed $19,494 for
treatments never provided to patients.
Insurance Fraud Prosecutor Gooden-Brown
said that Lunic Adisson also pleaded guilty
to an unrelated charge of simulating a
motor vehicle insurance identification
card contained in a June 27, 2003 Essex
County Grand Jury indictment. The indictment
charged that Adisson produced and supplied
a motor vehicle insurance identification
card to an Irvington, Essex County, police
officer in order to regain possession
of her impounded vehicle. The charge arose
from a separate investigation conducted
by the Office of the Insurance Fraud Prosecutor.
The investigation and prosecution was
coordinated by the Division
of Criminal Justice - Office
of the Insurance Fraud Prosecutor
which investigates and prosecutes civil
and criminal insurance fraud cases. State
Investigators Anne Hayes and Anthony Abarno,
Civil Investigator Errol English, and
Deputy Attorneys General Lewis Korngut,
Richard Queen, and Andrew Fried were assigned
to the investigation. The Newark Police
Department assisted in the investigation.
#
# #
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