New Jersey Attorney General Peter Harvey announced that an Essex County doctor and his niece have been charged by the Division of Criminal Justice – Office of Insurance Fraud Prosecutor with reportedly falsifying medical records and submitting nearly $50,000 in fraudulent bills to various insurance companies.
According to Vaughn McKoy, Director, Division of Criminal Justice and Insurance Fraud Prosecutor Greta Gooden Brown, LeClerc Adisson, 56, and his niece, Lunic Adisson, 32, of Walter Place, Irvington, Essex County, were charged via a State Grand Jury indictment with Health Care Claims Fraud (2nd degree), theft by deception (3rd degree), misconduct by a corporate official (3rd degree), and falsifying records (4th degree). If convicted on all counts, each defendant faces up to 211/2 years in state prison and fines of up to $195,000. In addition, each defendant faces the possibility of civil insurance fraud fines pursuant to the Insurance Fraud Prevention Act.
The State Grand Jury indictment alleges that between April, 1997 and December, 2000, LeClerc Adisson, a licensed medical doctor who practiced medicine in East Orange, Essex County, concealed the fact that he owned and had a financial interest in two corporations – Dantor Medical Supply and Clara Medical Services. The indictment charges that Lunic Adisson assisted her uncle by concealing his ownership interest in Dantor and Clara Medical and by submitting fraudulent bills to insurance companies for medical supplies and related services.
The indictment charges that many of the insurance billings were fraudulent in that they were inflated, charged for services and/or supplies that were not prescribed by a treating chiropractic physician, and/or charged for services and medical supplies that were never provided to patients. In total, it is alleged that LeClerc and Lunic Adisson fraudulently billed insurance carriers $48,273.
Insurance Fraud Prosecutor Brown noted that the Zurich Insurance Group, Sentry Insurance Company, New Jersey Manufacturers Insurance Company, Progressive Insurance Company, MDA Insurance Company, Liberty Mutual Insurance Company, Keystone Insurance Company, Prudential Insurance Company, Clarendon Insurance Company, and State Farm Insurance Company paid Adisson $26,028 as a result of the fraudulent billings.
The indictment was handed up to Mercer County Superior Court Judge Linda R. Feinberg, the Assignment Judge in charge of the State Grand Jury, on July 29.
The case will be assigned to the Essex County Superior Court for trial. The Adisson’s will be ordered to appear for arraignment and bail on a date to be determined. The case will also be referred to the Board of Medical Examiners for action as it relates to LeClerc Adisson’s medical license.
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