TRENTON - Attorney General Peter C. Harvey
announced that a Passaic County doctor
has been sentenced to state prison after
pleading guilty to submitting nearly $10,000
in phony health care claims which charged
insurance companies for medical services
that were never provided to patients.
Additionally, the doctor’s former
office manager was ordered to pay a $7,500
civil insurance fraud fine.
According to Vaughn L. McKoy, Director,
Division of Criminal Justice and Insurance
Fraud Prosecutor Greta Gooden-Brown, Angel
R. Lobo, M.D., 70, Garden City, NY, was
sentenced by Passaic County Superior Court
Judge Miguel A. de la Carrera to three
years in state prison and ordered to pay
a $100,000 civil insurance fraud fine
pursuant to the Insurance Fraud Prevention
Act. Lobo’s office manager, Mercy
Lobo (no relation), 59, Clifton, Passaic
County, was sentenced to 15 months probation
and ordered to pay a $7,500 civil insurance
fraud fine. The sentences were imposed
by Judge de la Carrera on Feb. 15.
Insurance Fraud Prosecutor Gooden-Brown
noted that Dr. Lobo pleaded guilty before
Judge de la Carrera to a charge of Health
Care Claims Fraud on Sept. 11, 2003, while
Mercy Lobo, pleaded guilty to Health Care
Claims Fraud on Oct. 30, 2003. Lobo was
licensed by the New Jersey Board of Medical
Examiners to practice medicine in 1974.
His license has been suspended by the
Board.
The investigation by the Office of Insurance
Fraud Prosecutor determined that Dr. Lobo
operated the Pain Management Clinic located
on 14th Street in Paterson. In pleading
guilty, Dr. Lobo admitted that he prepared
false patient records to reflect that
certain health care services were administered
to patients when no such services were
provided. The fraudulent billings were
submitted to Parkway Insurance Company
and/or AIG Claims Services, Inc. Lobo
also admitted to submitting more than
$6,400 in false automobile insurance Personal
Injury Protection (PIP) health care claims
to Parkway Insurance Company and more
than $2,150 to AIG Claims Services, Inc.
in connection with the treatment of persons
purportedly injured in automobile accidents.
Mercy Lobo admitted that she assisted
Dr. Lobo in obtaining, using and paying
“runners” to secure patients
for the medical practice. (A runner is
a person paid by a licensed medical service
provider to procure patients for the medical
practice so that insurance claims can
be submitted for providing treatment.)
Additionally, Lobo admitted instructing
patients to sign-in at The Pain Management
Clinic on dates that the patient did not
appear for treatment.
The investigation by the Division
of Criminal Justice - Office
of Insurance Fraud Prosecutor included
the use of undercover state investigators
posing as “runners” and patients
at The Pain Management Clinic. State Investigator
Joseph Luccarelli and Deputy Attorney
General Michael A. Monahan coordinated
the investigation. DAG Monahan prosecuted
the case.
Noting that some important cases have
begun with anonymous tips from the public,
Insurance Fraud Prosecutor Gooden Brown
encouraged anyone with information about
insurance fraud to contact the Division
of Criminal Justice - Office of Insurance
Fraud Prosecutor’s toll-free hotline
at 1-877-55-FRAUD, or
to visit the insurance fraud web site
at www.NJInsurancefraud.org.