Former CPA Hit with Charges in Claims Scam

September 21, 2004

New Jersey Attorney General Peter Harvey announced that a former Bergen County certified public accountant has been charged by the Division of Criminal Justice – Office of Insurance Fraud Prosecutor with Health Care Claims Fraud, theft, and misconduct by a corporate official for submitting more than $350,000 in inflated and fraudulent insurance claims for medical services that were never provided to patients.

According to Vaughn McKoy, director, Division of Criminal Justice and Insurance Fraud Prosecutor Greta Gooden Brown, Barry Cohen, 51, Parkland, Fla., was charged via a State Grand Jury indictment with second degree Health Care Claims Fraud, theft by deception, and misconduct by a corporate official. A second degree crime carries a maximum penalty of up to ten years in state prison and a fine of up to $150,000. Additionally, Cohen faces possible civil insurance fraud fines pursuant to the Insurance Fraud Prevention Act.

Gooden Brown said that the State Grand Jury indictment alleges that Cohen operated a family-owned corporation known as Headways Inc., formerly located in Bergen County. Headways, which ceased operations in November, 2000, provided health care services and therapy to patients suffering from brain injuries.

The indictment charges that between Jan. 15, 1998 and April 30, 2001, Cohen fraudulently increased the amounts billed to insurance companies and/or self-funded health benefit plans for patient therapy and related treatments by adding additional hours and/or dates of therapy which were never provided. The investigation uncovered information that Cohen allegedly added more than 9,000 additional hours of services totaling more than $350,000 to billings submitted to the insurance companies for reimbursement or payment.

The insurance companies and health benefits plans that received the false claims included Allstate Insurance Company, Horizon Blue Cross/Blue Shield of New Jersey, State Farm Insurance Company, Proformance Mutual Insurance Company, and Key Benefit Administrators, a third party claims administration company which administered health insurance for the Teamsters Union Local 560 Benefit Fund, as well as the New Jersey Automobile Full Insurance Underwriting Association.

The indictment was handed up to Mercer County Superior Court Judge Linda Feinberg, the Assignment Judge in charge of the State Grand Jury, on Sept. 8. The case will be assigned to the Bergen County Superior Court for trial.

Cohen will be ordered to appear in Court for arraignment and bail.

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