Strength And Conditioning Coach Admits Role In Insurance Billing Scheme
TRENTON, N.J. – A partner in Source Institute for Human Performance, a Princeton, N.J., provider of exercise coaching services to independent high schools, pleaded guilty today to defrauding insurance companies by falsely claiming that Source gave clients physical therapy, U.S. Attorney Paul J. Fishman announced.
David Nogaki, 42, of North Brunswick, N.J., pleaded guilty before U.S. District Judge Peter G. Sheridan in Trenton federal court to an information charging him with one count of conspiracy to commit health care fraud.
According to documents filed in this case and statements made in court:
Nogaki was a partner in Source Institute for Human Performance, which provided exercise, strength, conditioning and performance coaching services to students, faculty and staff at certain independent high schools in New Jersey. Nogaki and his conspirators at Source developed a scheme to enrich themselves by billing their personal training sessions as physical therapy services covered by health insurance – even though no one at Source was a physical therapist.
Nogaki and his conspirators would ask clients for their health insurance information and then lie to the insurance companies, indicating Source provided physical therapy. Some clients came to Source with a doctor’s prescription for physical therapy, and Source would treat those individuals under the prescription and then bill insurers. For other clients who had never seen a doctor, Nogaki made up his own diagnosis and then billed insurers as if he had provided physical therapy.
Nogaki admitted submitting claims to AmeriHealth, Aetna, Horizon Blue Cross Blue Shield of New Jersey and United Healthcare. Source received over $200,000 in fraudulent insurance payments from the scheme.
Nogaki faces a maximum potential penalty of 10 years in prison and a fine of $250,000, or twice the gross gain or loss caused by his offense. Sentencing is currently scheduled for May 5, 2014.
U.S. Attorney Fishman credited agents of the FBI’s Trenton Resident Agency, under the direction of Special Agent in Charge Aaron T. Ford, with the investigation.
The government is represented by Assistant U.S. Attorney R. David Walk Jr. of the U.S. Attorney’s Office Health Care and Government Fraud Unit.
Defense counsel: Roberto Cuan Esq., Teaneck, N.J.