Attorney General Gurbir S. Grewal and the Office of the Insurance Fraud Prosecutor today announced that a Passaic County pain management doctor has been charged with first-degree conspiracy and money laundering for allegedly submitting more than $4.4 million in fraudulent bills for service to insurance companies that netted him more than $500,000 in a medical kickback fraud scheme he operated.
Officials said Dr. Todd Koppel, 51, a New York City resident who ran the Garden State Pain Management in Clifton, allegedly paid more than $190,000 in kickbacks to five chiropractors in exchange for more than 790 patient referrals to his pain management facility between 2006 and 2016.
Three of those chiropractors have admitted to participating in the scheme and accepting kickbacks from Koppel. The investigation is ongoing.
According to authorities, Koppel is the latest doctor charged in connection with an ongoing investigation by the Attorney General’s Commercial Bribery Task Force, which was formed in January 2016 to target commercial bribery in the healthcare industry.
The task force, which includes deputy attorneys general and detectives from the Division of Criminal Justice Financial & Computer Crimes Bureau and the Office of the Insurance Fraud Prosecutor, has uncovered a statewide criminal enterprise in which doctors receive hundreds of thousands of dollars in illegal kickbacks in return for providing patient referrals worth millions of dollars to other doctors and medical service providers.
“Through its continued hard work, the Commercial Bribery Task Force has identified and dismantled yet another unsavory alliance of medical fraudsters who treated patients as pawns to be bought and sold for profit,” said Attorney General Grewal. “As the alleged operator of this criminal enterprise, Dr. Koppel not only stole hundreds of thousands of dollars from insurance companies, he deprived patients of their right to be treated by doctors whose medical decisions were not clouded by unadulterated greed.”
According to the indictment, over a 10-year span Koppel billed various insurance companies more than $4.4 million for medical treatments for patients referred to him by the five chiropractors.
In submitting the fraudulent claims, Koppel allegedly omitted the material fact that the treatments were the result of an illegal kickback scheme. Koppel received more than $500,000 in insurance payments from his criminal activities, which were deposited into GSPM’s business accounts and later moved to his personal bank accounts, according to the indictment. Koppel allegedly used some of the ill-gotten proceeds to generate cash to pay additional kickbacks.
Three chiropractors involved in the scheme have admitted receiving kickbacks from Koppel. All three previously pleaded guilty to charges related to the prosecution of other medical kickback rings. They are:
· Phillip Potacco, former operator of the South Orange Trauma and Rehab Center (SOTC) in South Orange, who pleaded guilty in a kickback scheme involving SOTC.
· Dr. Ronald Hayek, former operator of Union Wellness Center in Totowa, who pleaded guilty in a kickback scheme involving medical imaging centers in North Jersey.
· Dr. Brian Beagin, a Woodland Park chiropractor who pleaded guilty to conspiracy and health care claims fraud (2nd degree) for his role in the kickback scheme involving medical imaging centers in North Jersey.
In an indictment handed up by a state Grand Jury in Trenton last week, Koppel was charged with:
· Conspiracy (1st degree),
· Money Laundering (1st degree)
· Misconduct by a Corporate Official (2nd degree)
· Theft by Deception (2nd degree)
· Health Care Claims Fraud (4 counts 2nd degree)
· Attempted Theft by Deception (2nd degree)
· Commercial Bribery (5 counts 3rd degree)
· Criminal Running (6 counts 3rd degree)
The charges are merely accusations and the defendant is presumed innocent until proven guilty.
First degree crimes carry a sentence of 10 to 20 years in state prison and a fine of up to $500,000. Second-degree charges carry a sentence of five to 10 years in state prison and a fine of up to $150,000 Third-degree crimes carry a sentence of three to five years in state prison and a criminal fine of up to $15,000.