N.J. Physician, Chiropractor Sentenced in Fraud Case

New Jersey Division of Criminal Justice Director Vaughn McKoy announced that the former operators of a Passaic County medical practice have been sentenced in Passaic County Superior Court for submitting more than $34,000 in fraudulent billings to insurance companies seeking inflated payments for medical services different than those actually provided to patients.

According to Insurance Fraud Prosecutor Greta Gooden-Brown, Alphonso Smith, 66, of Woodbury, Gloucester County, and Daniel Catanzaro, 44, Cartersville, Georgia, were sentenced by Passaic County Superior Court Judge Garry Rothstadt on Aug. 5 to probation, ordered to pay $9,400 in restitution, and to pay court costs. As part of the probation, Catanzaro must perform 200 hours of community service. In addition, both defendants have had their respective medical licenses suspended.

In pleading guilty on May 3 before Judge Rothstadt to charges of Health Care Claims Fraud, Smith and Catanzaro reportedly admitted that from July, 1997 through March, 1999, to submitting more than $34,000 in fraudulent and/or inflated bills to at least four separate insurance companies.

An investigation and audit conducted by the Division of Criminal Justice – Office of Insurance Fraud Prosecutor determined that Smith and Catanzaro submitted at least 92 fraudulent billings seeking insurance reimbursements for more expensive injected anesthesia when, in fact, the services administered to patients were less expensive non-invasive electrical stimulation therapy. Smith and Catanzaro submitted the fraudulent health and automobile insurance claims to the Oxford Health Care Insurance Company, New Jersey Manufacturers Insurance Company, United Health Care, and Allstate Insurance Company.

Prosecutor Gooden-Brown noted that Smith, a licensed medical doctor, and Catanzaro, a licensed chiropractor, operated the Quality Care Physicians d/b/a Physicians Plus, medical practice in Wayne, Passaic County. The investigation determined that Smith founded the medical practice and was the medical director and sole shareholder, while Catanzaro ran the facility on a day-to-day basis.