TRENTON
- Attorney General Peter C. Harvey announced
that the Division of Criminal Justice
- Office of Insurance Fraud Prosecutor,
in conjunction with the Division of Consumer
Affairs, has charged a former North Jersey
chiropractor with continuing to practice
chiropractic medicine after his chiropractic
license was suspended and then submitting
nearly $100,000 in billings to insurance
companies for medical services and treatments
provided to patients while his license
was suspended.
According to Vaughn L. McKoy, Director,
Division of Criminal Justice and Insurance
Fraud Prosecutor Greta Gooden Brown, Philip
Potacco, 53, Miller Road, Kinnelon, Morris
County, was charged via a two-count State
Grand Jury indictment with Health Care
Claims Fraud and attempted theft by deception
(both 2nd degree). If convicted on both
charges, Potacco faces up to 20 years
in state prison and a fine of up to $300,000.
Potacco also faces possible civil insurance
fraud fines. Potacco will be ordered to
appear in Essex County Superior Court
for arraignment and bail on a date to
be determined by the Court.
"This
defendant blatantly continued to practice
chiropractic medicine even though his
license was suspended. His alleged actions
put the health of patients at risk and
cheated New Jersey insurance companies
out of tens-of-thousands of dollars,"
said Attorney General Harvey. "My
office is taking direct aim at such corrupt
schemes and will continue to aggressively
investigate, arrest, and prosecute medical
professionals involved in insurance fraud."
The State Grand Jury indictment alleges
that from Dec.1, 1996 through Sept. 30,
2000, Potacco practiced chiropractic medicine
even though his license had been suspended
by the Board of Chiropractic Examiners
on three separate occasions since 1985.
An investigation by the Division of Criminal
Justice - Office of Insurance Fraud Prosecutor
determined that, despite not having a
valid license to practice chiropractic
medicine, Potacco continued to treat patients
and provide chiropractic procedures while
employed at chiropractic facilities located
in Little Falls (Passaic County) and South
Orange (Essex County).
The indictment charges that after performing
the unlicensed chiropractic procedures,
Potacco billed First Trenton Insurance
Company, New Jersey Manufacturers Insurance
Company, and State Farm Insurance Company,
$98,175 in connection with the treatment
of patients purportedly injured in automobile
accidents. The insurance companies paid
Potacco $48,022 of the total amount billed.
On May 15, 2002, the Chiropractic Board
accepted the voluntary surrender of Potacco’s
license for practicing chiropractic medicine
while suspended.
State Investigators Dennis Mazone and
Laura Parisi, Civil Investigator Errol
English, and Deputy Attorney General Nicholas
Vasile were assigned to the investigation.
DAG Vasile represented the Division of
Criminal Justice - Office of Insurance
Fraud Prosecutor before the State Grand
Jury. The case was referred to the Office
of Insurance Fraud Prosecutor by the State
Farm Insurance Company and the Division
of Consumer Affairs’ Enforcement
Bureau.
“Fraud
by professional health care providers
is particularly disturbing as the integrity
of the entire health care insurance claims
process depends on the trustworthiness
of the licensed professionals involved.
The Office of Insurance Fraud Prosecutor
will vigorously investigate and prosecute
this type of criminal activity,”
said Insurance Fraud Prosecutor Brown.
The indictment was returned to Mercer
County Superior Court Judge Linda R. Feinberg
on Sept. 6. An indictment is merely an
accusation. The defendant is presumed
innocent unless and until proven guilty
beyond a reasonable doubt in a Court of
law.
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