Bergen County, New Jersey, Doctor Admits Billing For Bogus Office Visits, Altering Patient Medical Records
NEWARK, N.J. – A family medicine physician with offices in Cresskill and Little Falls, New Jersey, today admitted defrauding Medicare, Medicaid and private insurance companies out of hundreds of thousands of dollars by billing them for non-existent office visits, U.S. Attorney Paul J. Fishman announced.
Albert Ades, 60, of Englewood, New Jersey, pleaded guilty before U.S. District Judge Esther Salas in Newark federal court to Count One of an indictment charging him with health care fraud.
According to the documents filed and statements made in court:
From 2005 through June 2014, Ades, a licensed family medicine doctor who owns and operates Albert Ades M.D., P.A., fraudulently billed Medicare, Medicaid and various private payors for face-to-face physician office visits that never happened. Ades wrote prescriptions, authorized refills or performed other tasks without ever seeing those patients on the billed dates. Ades admitted today that he also altered patients’ medical charts by inserting fabricated blood pressure readings, other vitals and clinical notes on patients’ charts to make it appear as if they had visited Ades’s office on the billed dates.
Ades admitted that, between 2009 and 2013, his scheme caused a loss of approximately $280,000 to federal health care benefit programs and private insurers.
The charge of health care fraud carries a maximum penalty of 10 years in prison and a $250,000 fine, or twice the gross gain or loss resulting from the offense. Sentencing is scheduled for Nov. 16, 2015.
U.S. Attorney Fishman credited special agents of the FBI, under the direction of Special Agent in Charge Richard M. Frankel; U.S. Department of Health and Human Services, Office of Inspector General, under the direction of Special Agent in Charge Scott J. Lampert; and investigators with the U.S. Attorney’s Office with the investigation leading to today’s plea.
The government is represented by Assistant U.S. Attorneys Jane H. Yoon and Danielle M. Corcione of the U.S. Attorney’s Health Care and Government Fraud Unit in Newark.
U.S. Attorney Paul J. Fishman reorganized the health care fraud practice at the New Jersey U.S. Attorney’s Office shortly after taking office, including creating a stand-alone Health Care and Government Fraud Unit to handle both criminal and civil investigations and prosecutions of health care fraud offenses. Since 2010, the office has recovered more than $635 million in health care fraud and government fraud settlements, judgments, fines, restitution and forfeiture under the False Claims Act, the Food, Drug and Cosmetic Act and other statutes.
Defense counsel: Alexander Spiro Esq., New York