Nicholas Huba
A 38-year-old doctor from the Cream Ridge section of Millstone Township has been indicted on 43 counts for allegedly submitting claims to insurance carriers for medical studies he never performed.
In the indictment against Hector Lopez, Acting Insurance Fraud Prosecutor Ronald Chillemi alleges that Lopez sought payment of $152,350 from the carriers for approximately 40 nerve condition studies conducted on 38 patients from September 2009 through April 2010.
According to the indictment, Lopez received between $53,811 and $58,117 from the insurance carriers for procedures that never took place. Nerve conduction studies are used as a medical diagnostic tool to evaluate the function and ability of the human body’s nerves.
Lopez has been charged with 40 counts of second-degree health care claims fraud, and one count each for second-degree attempted theft by deception, third-degree theft by deception and fourth-degree falsifying records.
The indictment alleges that Lopez conducted the procedures at Performance Spine and Sports Medicine in Lawrence, a clinic of which Lopez was a founding partner. Lopez’s colleagues at the clinic discovered his scam, forced him out of the medical partnership and also required him to repay what he had allegedly stolen. The staff later reported Lopez behavior to the state Board of Medical Examiners. That board suspended his medical license for three years, beginning on June 14, 2011. Lopez’s license remains suspended.
“The defendant was ensnared by his partners, has had to surrender his license, and is now facing significant time in prison for his alleged misdeeds,” Acting Insurance Fraud Prosecutor Ronald Chillemi said in a statement. “He has been rebuked by those in his profession, and will now have to answer to a jury of his peers.”
The second-degree crimes carry a maximum sentence of 10 years in state prison and a criminal fine of up to $150,000, while third-degree crimes carry a maximum sentence of five years in state prison and a criminal fine of up to $15,000. Fourth-degree crimes carry a maximum sentence of 18 months in state prison and a criminal fine of up to $10,000.
Source: app
