Vaughn McKoy, director, Division of Criminal Justice, announced that New Jersey’s Office of Insurance Fraud Prosecutor has obtained State Grand Jury indictments charging an Essex County chiropractor and his office staff with seeking hundreds of dollars in insurance payments for medical services that were never provided. A second indictment charged the chiropractor with narcotics-related violations.
Insurance Fraud Prosecutor Greta Gooden Brown, said that Dr. Richard Herbert, 47, of Point Pleasant, Ocean County, and office workers Melisa Caraballo, 31, of Davenport, Fla. and Monique Hernandez, 31, of Tobyhanna, Pa., were each charged with conspiracy (2nd degree), two counts of Health Care Claims Fraud (2nd degree), and attempted theft by deception (3rd degree). A second degree crime is punishable by up to ten years in state prison and a fine of up to $150,000. A third degree crime carries a maximum penalty of up to five years in state prison and a fine of up to $15,000. The defendants also face possible civil insurance fraud fines pursuant to the Insurance Fraud Prevention Act.
Gooden-Brown noted that the indictment, which resulted from an undercover investigation into fictitious motor vehicle accidents, alleges that Herbert, a New Jersey-licensed chiropractor, in concert with Caraballo and Hernandez, conspired to commit health care claims fraud and theft by seeking insurance payments for medical procedures and services that were never provided to patients.
The indictment alleges that Herbert instructed office staff to submit automobile insurance PIP claims totaling $2,219 to the GSA Insurance Company seeking payment for non-existent professional diagnostic tests or treatments. The indictment charges that the fraudulent billings were submitted to the insurance company on nine separate dates between October, 1998 and November, 1999. Herbert’s chiropractic office, Rehab Associates, was located in East Orange, Essex County.
A separate State Grand Jury indictment charged Herbert with three counts of third degree attempting to obtain a controlled dangerous substance. The indictment charges that Herbert impersonated a former colleague, contacted various pharmacies, and illegally ordered controlled prescription drugs – specifically Tylenol with codeine, Diazepam, Lortab, and Acetaminophen with codeine.
The indictments were handed-up to Mercer County Superior Court Judge Linda Feinberg, the Assignment Judge in charge of the State Grand Jury on Oct. 1. The case has been assigned to the Essex County Superior Court for trial. Herbert, Caraballo, and Hernandez will be notified via complaint summons to appear in Essex County Superior Court for arraignment and bail.
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