Two Chiropractors, an Orthopedist, and a Runner Arrested for Illegal

Transcription

Two Chiropractors, an Orthopedist, and a Runner Arrested for Illegal
NEWS RELEASE
Prosecutor Camelia M. Valdes
Passaic County Prosecutor’s Office
401 Grand Street
Paterson, NJ 07505
(973) 881-4800
TWO CHIROPRACTORS, AN ORTHOPEDIST, AND A RUNNER
ARRESTED FOR ILLEGAL INSURANCE SCHEME
PATERSON, NEW JERSEY:
June 4, 2015
Passaic County Prosecutor Camelia M. Valdes announces the arrest of Dr. Kenneth
Gross, D.C., age 44, and his wife, Dr. Michelle Dubnoff, D.C., age 45, both of
Morganville, New Jersey, Dr. James Morales, M.D., an orthopedist, age 45, of Toms
River, New Jersey, and James Hill, age 50, of Hasbrouck Heights, New Jersey.
Dr. Kenneth Gross, a chiropractor, ran his practice out of Chiropractic Physicians
Group, 293 Passaic Avenue, Passaic, New Jersey. Dr. Gross submitted false billing, false
medical and chiropractic notes. Dr. Gross paid James Hill for illegal “running” to refer
patients to his practice so that he could treat them and then file claims with their insurance
companies. Payments to James Hill were laundered and disguised. James Hill failed to
pay New Jersey income tax returns on these funds.
Dr. Gross’s wife, Dr. Michelle Dubnoff, a chiropractor, ran her practice out of
Ocean Wellness Center, 1868 Hooper Avenue, Toms River, New Jersey, Suite 3. Dr.
James Morales, an orthopedist, ran his practice out of Shore Sports Medicine, 1868
Hooper Avenue, Toms River, New Jersey, Suite 5. Dr. Gross, Dr. Dubnoff, and Dr.
Morales engaged in an illegal referral scheme, referring patients to and amongst
themselves to commit health care claims fraud and to maximize insurance payments.
Billing records were submitted by the defendants to various insurance carriers on
behalf of Chiropractors Physician Group (Dr. Kenneth Gross), Shore Sports Medicine (Dr.
James Morales), and Ocean Wellness Center (Dr. Michelle Dudnoff) that created or
reinforced a false impression that said entities were independent of each other and referrals
were made on an arm’s length professional basis for the best interest of the patients. In
fact, the defendants and corporate entities they controlled are directly related by family and
financial interconnection in violation of New Jersey State law.
Dr. Kenneth Gross is charged with Illegal Running (3rd degree) (N.J.S.A. 2C:2122.1), Conspiracy to Commit Health Claims Fraud (2nd degree) (N.J.S.A. 2C:5-2/2C:214.3), Commercial Bribery (3rd degree) (N.J.S.A. 2C:21-10), and Health Claims Fraud (2nd
degree) (N.J.S.A. 2C:21-4.3).
Dr. James Morales is charged with Conspiracy to Commit Health Claims Fraud (2nd
degree) (N.J.S.A. 2C:5-2/2C:21-4.3), Commercial Bribery (3rd degree) (N.J.S.A. 2C:2110), and Health Claims Fraud (2nd degree) (N.J.S.A. 2C:21-4.3).
Dr. Michelle Dubnoff is charged with Conspiracy to Commit Health Claims Fraud
(2 degree) (N.J.S.A. 2C:5-2/2C:21-4.3).
nd
James Hill is charged with Illegal Running (3rd degree) (N.J.S.A. 2C:21-22.1),
Conspiracy to Commit Health Claims Fraud (3rd degree) (N.J.S.A. 2C:5-2/2C:21-4.3),
Failure to File Returns (Tax Evasion) (3rd degree) (N.J.S.A. 54:52-8), Failure to Pay (3rd
degree) (N.J.S.A. 54:52-9), Money Laundering (2rd degree) (N.J.S.A. 2C:21-25).
Third degree crimes are punishable by three to five years in New Jersey State
Prison. Second degree crimes are punishable by five to ten years in New Jersey State
Prison.
Special thanks to Ocean County Prosecutor’s Office, under the leadership of
Prosecutor Joseph Coronato, the New Jersey Attorney General’s Office, Office of the
Insurance Fraud Prosecutor, under the leadership of Insurance Fraud Prosecutor Ronald
Chillemi, the police department of Passaic, Paterson, Toms River and Hasbrouck Heights,
and the National Insurance Crime Bureau.
The investigation is continuing. Passaic County Chief Assistant Prosecutor Jay W.
McCann is prosecuting the case against the defendants, and if you have any questions, he
may be reached at (973) 837-7616 or jmccann@passaiccountynj.org.
A criminal complaint is merely an accusation. Despite this accusation, the
defendants are presumed innocent unless and until proven guilty beyond a reasonable
doubt.
Dr. James Morales, M.D., 45
Toms River, New Jersey
Dr. Michelle Dubnoff, D.C., 45
Morganville, New Jersey
Dr. Kenneth Gross, D.C., 44
Morganville, New Jersey
James Hill, 50
Hasbrouck Heights, New Jersey

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