Bergen County, New Jersey, Doctor Who Billed For Bogus Office Visits, Altered Patient Medical Records Sentenced To More Than Three Years In Prison
NEWARK, N.J. – A family physician with offices in Cresskill and Little Falls, New Jersey, was sentenced today to 37 months in prison for defrauding Medicare, Medicaid and private insurance companies out $280,000 by billing them for non-existent office visits, U.S. Attorney Paul J. Fishman announced.
Albert Ades, 61, of Englewood, New Jersey, previously pleaded guilty before U.S. District Judge Esther Salas to Count One of an indictment charging him with health care fraud. Judge Salas imposed the sentence today in Newark federal court.
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 that he 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.
In addition to the prison term, Judge Salas sentenced Ades to three years of supervised release and ordered him to forfeit $280,000.
U.S. Attorney Fishman credited special agents of the FBI, under the direction of Acting Special Agent in Charge Andrew Campi; 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 sentencing. U.S. Attorney Fishman also thanked the National Insurance Crime Bureau for their assistance with the investigation.
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 $1.29 billion 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