New York Doctor Sentenced for Health Care Claims Fraud

Doctor Stole More Than $2 Million From 20 Insurance Companies

August 10, 2007 -- TRENTON - New Jersey Attorney General Anne Milgram and Criminal Justice Director Gregory A. Paw announced that a New York physician was sentenced today for defrauding insurance companies of more than $2 million by submitting numerous false Personal Injury Protection (PIP) auto insurance claims.

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According to Insurance Fraud Prosecutor Greta Gooden Brown, Juan Carlos Fischberg, 59, of New York City, was sentenced to three years in state prison by Superior Court Judge Patricia Del Bueno Cleary in Monmouth County. He also was ordered to pay $2,126,243 in restitution and a $50,000 civil insurance fraud fine. Fischberg was sentenced pursuant to his May 24 guilty plea to second-degree health care claims fraud, a charge contained in an Oct. 11, 2006 state grand jury indictment.

At his guilty plea hearing, Fischberg, the former owner and operator of Hudson Rehabilitation and Medical Center in West New York, admitted that he billed for electro-diagnostic services, including nerve conduction velocity tests that were not completed. Nerve conduction velocity tests are sometimes used to diagnose injuries to patients as the result of automobile accidents. Most of the claims submitted by Fischberg were submitted to automobile insurance companies.

Investigators from the Office of Insurance Fraud Prosecutor seized and reviewed patient records for more than 5,000 of Fischberg’s patients and determined that Fischberg falsified nerve conduction study results for his patients.

As part of the investigation, OIFP seized Fischberg’s office building in Jersey City and sold it for $452,000. That money was forfeited to the state along with approximately $64,000 contained in several bank accounts. The Office of Insurance Fraud Prosecutor also filed civil complaints for injunctive relief in both New Jersey and Delaware courts to stop Fischberg from transferring any money from a family trust. As a result of all of these efforts, it is anticipated that the state and the insurance companies will realize more than $2.5 million in restitution, forfeited assets and fines.

State Investigators Laura Parisi and Robyn Greene, Civil Investigator Chris Gasbarro, and Deputy Attorneys General Cheryl Maccaroni, Steven Farman and Stephen Cirillo were assigned to the investigation. They received extensive assistance from the OIFP Analytical Support Unit, and from the attorneys in the Division of Law who prosecute medical licensing cases. Maccaroni represented the Office of Insurance Fraud Prosecutor at the sentencing.

“Doctors who file false claims undermine the integrity of the health care claims process,” said Insurance Fraud Prosecutor Brown. “We will thoroughly investigate licensed professionals who are referred to the Office of Insurance Fraud Prosecutor because of fraud, in order to ensure that they are held responsible for their crimes.”

This case was referred to OIFP by the Special Investigative Units of several insurance companies which initially uncovered the fraud and assisted OIFP in the investigation. Insurance Fraud Prosecutor Brown thanks the insurance companies for their involvement in this matter.

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.

Source: New Jersey Attorney General