N.J. Physician, Office Manager Plead Guilty to Insurance Fraud Charges

New Jersey Attorney General Peter Harvey announced that an Essex County physician and his fiancé/office manager have pleaded guilty to Health Care Claims Fraud for submitting more than $2,6000 in fraudulent bills to an insurance carrier for medical services that were never provided.

According to Vaughn McKoy, director, Division of Criminal Justice and Insurance Fraud Prosecutor Greta Gooden-Brown, Patrick Manze, 57, of Bloomfield, Essex County, and Michelle Maglione, 50, also of Bloomfield, pleaded guilty before Essex County Superior Court Judge Donald Volkert, Jr. to separate Accusations filed by the Division of Criminal Justice – Office of Insurance Fraud Prosecutor. Manze pleaded guilty to Health Care Claims Fraud (3rd degree), while Maglione pleaded guilty to Health Care Claims Fraud (4th degree). A third degree crime carries a maximum sentence of up to five years in state prison and a fine of up to $15,000. A fourth degree crime carries a maximum sentence of up to 18 months in state prison and a fine of up to $10,000.Volkert also signed an order suspending Manze’s medical license for one year.

Gooden-Brown noted that Maglione admitted she solicited health insurance information from a friend so that fraudulent insurance claims could be submitted under the pretense that the friend was to become a patient of Dr. Manze.

An investigation by the Division of Criminal Justice – Office of Insurance Fraud Prosecutor reportedly determined that Manze utilized the third party health insurance information solicited by Maglione to submit at least two fraudulent health insurance claims to Horizon Blue Cross/Blue Shield.

Manze admitted that he falsified reimbursement billings for an office examination and certain diagnostic tests, including a cystoscopy, a cystometrogram and for two ultrasound studies that were never performed. The fraudulent billings totaled $2,625.