Doctor Sentenced to Two Years for Health Care Fraud

North Caldwell doctor pleaded guilty to filing hundreds of false claims for services which were never rendered.

A doctor from North Caldwell was sentenced in Newark federal court Monday to two years in prison for health care fraud. 

Dr. , 63, pleaded guilty in December to defrauding Blue Cross Blue Shield of more than $725,000 by filing false claims for services that were not rendered and office visits that never occurred, according to a release issued by the office of U.S. Attorney Paul J. Fishman.

The sentence was imposed by U.S. District Judge Ester Salas, who previously presided over the guilty plea.

Stein was the owner of Randolph Otolaryngology P.C., a medical treatment facility based in Randolph, from August 2004 to September 2010. Before the fraudulent claims were billed, Stein had billed Blue Cross Blue Shield for treating a patient with the initials J.F. for nasal problems.

Stein admitted he submitted claims for approximately 900 nasal endoscopies he purportedly conducted on the patient, when only a few were actually performed. Stein also admitted he filed fraudulent claims for office visits and medical procedures that purportedly occurred while J.F. was out of the country on vacation.

As a result of the false claims, Stein received $725,156.45 from Blue Cross Blue Shield. Stein agreed to pay restitution and forfeiture in the same amount under the plea agreement. 

In addition to the prison term, Judge Salas sentenced Stein to three years of supervised release. He has also surrendered his medical license.

Bridget April 10, 2012 at 12:32 AM
Greed greed greed. How much money do you need to be happy?
Diane Mensinger April 10, 2012 at 11:39 AM
I believe the correct word is plead guilty not pleaded...
Kathy Pigott April 10, 2012 at 01:57 PM
You need to be your own patient advocate and check every E.O.B. (Explanation of Benefits) that you receive from your insurance company. Make sure you are only responsible for "patient owes" and do not pay anymore. If you were not in the office for D.O.S. (date of service) call your insurance company. This is a perfect example of why we're paying such high premiums for health insurance.
Danelectro59 April 11, 2012 at 11:16 AM
Diane: I think you meant "pled". In any event, "pled" and "pleaded" ar both commonly used in the law.


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