N.J. Electrologist Charged in Billing Scam

New Jersey Attorney General Peter Harvey announced that a Passaic County electrologist has been convicted on charges of attempting to bilk New Jersey insurance companies out of more than $900,000 in reimbursement payments by billing common electrolysis as a medically necessary cosmetic procedure – a procedure the electrologist was unable to perform.

According to Vaughn McKoy, director, Division of Criminal Justice and Insurance Fraud Prosecutor Greta Gooden-Brown, Florence Acquaire, 63, of Wayne, was convicted on April 14 by Passaic County Superior Court Judge Randolph Subryan following a 10-day bench trial.

Acquaire operated the High Mountain Medical Center, 342 Hamburg Pike in Wayne. Acquaire was convicted of Health Care Claims Fraud, theft by deception, and attempted theft by deception. Acquaire could be sentenced to more than 10 years in state prison, fined over $150,000, and ordered to pay civil insurance fraud fines pursuant to the civil Insurance Fraud Prevention Act. Sentencing is scheduled for June 24.

In finding Acquaire guilty, Judge Subryan reportedly determined that from July 25, 1998 through April 12, 2001, Acquaire submitted dozens of fraudulent health insurance claims seeking more than $908,843 in reimbursement payments from the United Health Group Insurance Company and the Aetna Insurance Company. The Aetna Insurance Company was billed $843,797, while United Health Group Insurance Company was billed $38,120.

A six-count State Grand Jury indictment returned on Oct. 30, 2003, alleged that Acquaire fraudulently billed electrolysis as a surgical debridement procedure – a medically necessary procedure which involves the surgical excision of dead skin and which must be performed by a doctor or other licensed medical service provider.

Acquaire is reportedly not a licensed medical service provider and was, therefore, not qualified to perform debridement or other surgical procedures and was ineligible to bill insurance companies the higher cost of the surgical procedure.