Morris County Resident with Revoked Medical License Pleads Guilty in Insurance Fraud Scam

TRENTON - Attorney General Zulima V. Farber and Gregory A. Paw, Director of the Division of Criminal Justice, announced that a Morris County resident whose New York medical license had been revoked has pleaded guilty to health care claims fraud and the unlicenced practice of medicine.

According to Insurance Fraud Prosecutor Greta Gooden Brown, Craig W. Gordon, 48, of River Edge Drive, Chatham, Morris County, pleaded guilty before Morris County Superior Court Judge Samuel V. Ahto to third degree practice of medicine by an unlicensed person and fourth degree health care claims fraud. The charges were contained in a Jan. 4, 2006 Morris County grand jury indictment filed by the Division of Criminal Justice - Office of the Insurance Fraud Prosecutor. Gordon is scheduled to be sentenced on June 9.

At the May 9 guilty plea hearing, Gordon, a former doctor whose State of New York medical license was revoked in 1995, admitted that between January 26, 2000 and January 18, 2001, he operated a business known as GFM Health Services out of his Chatham residence. An investigation by the Division of Criminal Justice - Office of the Insurance Fraud Prosecutor and Horizon Blue Cross/Blue Shield of New Jersey (HBCBSNJ) determined that Gordon referred to himself as "Dr. Gordon" while taking patients’ pulses and blood pressures. He caused claims to be submitted under an associate’s name to HBCBSNJ through the Medicare program for treatments to two patients for these services. The claims created the false impression that health care services had been provided by another physician when, in fact, they were either provided by Gordon, who is not a licensed practitioner, or not provided at all. As a result of the scam, HBCBSNJ paid out more than $10,900 in claims.

State Investigator Robyn Greene and Deputy Attorney General Nicole D. Rizzolo handled the case for the Office of Insurance Fraud Prosecutor.

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