N.J. Chiropractor Has Back Up Against Wall; Guilty Plea Offered in Fraud Case

May 13, 2004

New Jersey Attorney General Peter Harvey announced that a Morris County chiropractor has pleaded guilty to theft for billing an insurance company for chiropractic treatments never performed.

According to Vaughn McKoy, director, Division of Criminal Justice and Insurance Fraud Prosecutor Greta Gooden Brown, Nicola Amato, D.C., 41, of Flanders, Morris County, pled guilty before Ocean County Superior Court Judge Peter Giovine to a criminal Accusation which charged one count of third degree theft by deception.

Amato faces up to five years in state prison and/or a fine of up to $15,000. Amato may also face civil insurance fraud fines pursuant to the civil Insurance Fraud Prevention Act. The case will be referred to the Professional Board which licenses chiropractors. Amato is scheduled to be sentenced on July 9.

Gooden Brown said that in pleading guilty, Amato reportedly admitted that while operating a chiropractic practice in Waretown, Ocean County, from April, 1997 through October ,1999, he submitted 1,784 fictitious insurance bills for 28 separate patients. Amato also admitted that he “padded” the insurance claims to reflect the administration of five or more chiropractic manipulations, when three or fewer manipulations were actually performed.

As a result, Horizon Blue Cross Blue Shield reimbursed Amato more than $27,348 in payments to which he was not entitled.

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