New Jersey Attorney General Peter Harvey announced that a Passaic County M.D. has pleaded guilty to various insurance fraud crimes, including paying “runners” to bring in patients, submitting phony health care insurance claims and billing for medical services that were never rendered to patients.
According to Vaughn McKoy, Director, Division of Criminal Justice and Insurance Fraud Prosecutor Greta Gooden Brown, Angel R. Lobo, M.D., 70, Garden City, N.Y., pled guilty to Health Care Claims Fraud (2nd degree) before Passaic County Superior Court Judge Miguel de la Carrera. The guilty plea was entered on Sept. 11.
A second degree crime carries a penalty of up to 10 years in state prison and a fine of up to $150,000. Lobo is scheduled to appear before Judge de la Carrera on Jan. 16, 2004 for sentencing.
Gooden Brown noted that Lobo was indicted by a State Grand Jury on Oct. 30, 2001. The indictment charged Lobo with conspiracy, Health Care Claims fraud, theft by deception and criminal use of runners. Also charged in the indictment was Lobo’s office manager, Mercy Lobo (no relation), 59, Clifton, Passaic County.
Lobo operated the Pain Management Clinic located on 14th Street in Paterson. Lobo has been licensed to practice medicine in New Jersey since 1974. Mercy Lobo’s case is pending in Passaic County Superior Court.
At the guilty plea hearing, Lobo reportedly admitted that he prepared false patient records to reflect that certain health care services were rendered when no such services were provided to patients. The fraudulent billings were submitted to Parkway Insurance Company and/or AIG Claims Services, Inc.
Lobo also reportedly admitted to submitting more than $6,400 in false automobile insurance Personal Injury Protection (PIP) health care claims to Parkway Insurance Company and more than $2,150 to AIG Claims Services, Inc. in connection with the treatment of persons purportedly injured in automobile accidents. State Investigators assigned to the Division of Criminal Justice – Office of Insurance Fraud Prosecutor arrested Lobo on June 12, 2001 and Mercy Lobo on July 16. Lobo was released on $35,000 bail.
As a licensed medical doctor, Lobo was charged as a practitioner under the New Jersey Health Care Claims Fraud statute which provides for the prosecution of criminally culpable persons who knowingly, or with criminal recklessness, submit false or fraudulent claims for payment or reimbursement of health care services. Under the Health Care Claims Fraud statute, both licensed health care practitioners and non-licensed persons can be criminally charged.
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