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For Immediate Release:  
For Further Information Contact:
June 29, 2005

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

 

Rachel Sacharow
609-984-1936

 

Former Bergen County CPA Ordered to Pay More than $433,000 after Pleading Guilty to Health Care Claims Fraud
Investigation Determined Businessman Inflated More than 4,000 Hours of Therapy and Related Services Provided to Severely Brain-Injured Patients

TRENTON - Division of Criminal Justice Director Vaughn L. McKoy announced that a former Bergen County certified public accountant has been ordered to pay more than $433,000 after pleading guilty to Health Care Claims Fraud for inflating and submitting fraudulent insurance claims for medical services that were never provided to patients.

According to Director McKoy and Insurance Fraud Prosecutor Greta Gooden-Brown, Barry Cohen, 51, Parkland, FL, was ordered by Bergen County Superior Court Judge Joseph Conte to pay $328,000 in restitution and a $105,000 civil fine. In addition, Cohen was sentenced to three years probation. On March 7, Cohen pleaded guilty to Health Care Claims Fraud, a charge which was contained in a State Grand Jury indictment filed by the Division of Criminal Justice - Office of Insurance Fraud Prosecutor on Sept. 8, 2004.

Insurance Fraud Prosecutor Gooden-Brown noted that Cohen operated a family-owned corporation known as Headways, Inc., formerly located in Bergen County. Headways, which ceased operations in November, 2000, provided health care services and therapy to patients suffering from brain injuries.

At the guilty plea hearing, Cohen admitted that between Jan. 15, 1998 and April 30, 2001, he knowingly submitted dozens of health care claims to insurance companies and/or self-funded health benefit plans for patient therapy and related treatments by adding additional hours and/or dates of therapy which were never provided. An investigation by the Division of Criminal Justice - Office of Insurance Fraud Prosecutor determined that Cohen added more than 4,000 additional hours of services totaling more than $350,000 to dozens of bills submitted to the insurance companies for reimbursement or payment.

The insurance companies and health benefits plans that received the false claims included Allstate Insurance Company, Horizon Blue Cross/Blue Shield of New Jersey, State Farm Insurance Company, Proformance Mutual Insurance Company, and Key Benefit Administrators, a third party claims administration company which administered health insurance for the Teamsters Union Local 560 Benefit Fund, as well as the New Jersey Automobile Full Insurance Underwriting Association.

State Investigator Abraham Aquino, Civil Investigator Douglas Graham, and Deputy Attorneys General Nicholas Vasile were assigned to the investigation. DAG Vasile represented the Division of Criminal Justice - Office of Insurance Fraud Prosecutor at the sentencing on June 24. The case was referred to the Office of Insurance Fraud Prosecutor by Horizon Blue Cross/Blue Shield of New Jersey.

The Division of Criminal Justice - Office of Insurance Fraud Prosecutor is committed to protecting New Jersey’s citizens from unscrupulous acts by combating insurance fraud in whatever form it takes,” said Insurance Fraud Prosecutor Greta Gooden-Brown. “When health care providers commit fraud it is particularly disturbing, because the integrity of the health care insurance claims process depends on the trustworthiness of the licensed professionals involved. As it has in the past, the Office of the Insurance Fraud Prosecutor will vigorously investigate and prosecute this type of criminal activity.”

Noting that some important cases have begun with anonymous tips from the public, Prosecutor Brown emphasized that individuals can make a difference. “We need people’s information, not their identities. People who are concerned about insurance cheating and have any information about a fraud can call our toll-free hotline at 1-877-55-FRAUD, or visit our Web site at www.NJInsurancefraud.org .”

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