New Jersey Attorney General Anne Milgram and Criminal Justice Director Gregory Paw announced that a Mercer County neurologist and his former office administrator pleaded guilty to conspiracy for fraudulently billing nine insurance companies more than $470,000. According to Insurance Fraud Prosecutor Greta Gooden Brown, Dr. Alan E. Ottenstein, 51, and his former office administrator, Jean Woolman, 58, pleaded guilty to third-degree conspiracy to commit theft by deception before Superior Court Judge Mitchel Ostrer in Mercer County. The corporation owned by Ottenstein, Lawrenceville Neurology Associates, P.A., which had offices in Lawrenceville, pleaded guilty to second-degree conspiracy. The guilty pleas stem from a state grand jury indictment obtained by the Office of Insurance Fraud Prosecutor in December 2005. Third-degree crimes carry a maximum sentence of five years in state prison and a fine of $15,000. As part of the plea agreement, Ottenstein will be required to sign consent judgments for restitution and civil insurance fraud fines totaling $500,000, and his firm will lose its corporate charter. The state agreed not to object to Woolman’s entry into the Pre-Trial Intervention program, subject to approval of the court and conditioned on her payment of a $10,000 civil fine and permanent forfeiture of her Pennsylvania real estate license. At the guilty plea hearing, Ottenstein reportedly admitted that he falsely billed insurance companies in several ways. Ottenstein reportedly admitted that he billed for certain treatments – treatments used for back injuries commonly claimed by auto accident victims – as surgical back procedures when, in fact, non-surgical, mechanical traction procedures were used. In addition, he reportedly admitted that he billed for use of medical supplies known as sterile trays in connection with epidural injections when, in fact, sterile trays were not used, and that he wrongfully billed for an additional “facility fee” for epidural injections when regulations prohibited billing such fees in the circumstances. Among the insurance companies reportedly falsely billed by Ottenstein were Aetna, AmeriHealth, Health Net, Horizon Blue Cross Blue Shield, MetLife, New Jersey Manufacturers, The Oxford Plan, State Farm and Zurich Insurance. Based on the Office of Insurance Fraud Prosecutor’s investigation, Ottenstein wrongfully billed approximately $477,000 to these companies.
Wednesday, February 13, 2008
N.J. Neurologist, Assistant Plead Guilty
New Jersey Attorney General Anne Milgram and Criminal Justice Director Gregory Paw announced that a Mercer County neurologist and his former office administrator pleaded guilty to conspiracy for fraudulently billing nine insurance companies more than $470,000. According to Insurance Fraud Prosecutor Greta Gooden Brown, Dr. Alan E. Ottenstein, 51, and his former office administrator, Jean Woolman, 58, pleaded guilty to third-degree conspiracy to commit theft by deception before Superior Court Judge Mitchel Ostrer in Mercer County. The corporation owned by Ottenstein, Lawrenceville Neurology Associates, P.A., which had offices in Lawrenceville, pleaded guilty to second-degree conspiracy. The guilty pleas stem from a state grand jury indictment obtained by the Office of Insurance Fraud Prosecutor in December 2005. Third-degree crimes carry a maximum sentence of five years in state prison and a fine of $15,000. As part of the plea agreement, Ottenstein will be required to sign consent judgments for restitution and civil insurance fraud fines totaling $500,000, and his firm will lose its corporate charter. The state agreed not to object to Woolman’s entry into the Pre-Trial Intervention program, subject to approval of the court and conditioned on her payment of a $10,000 civil fine and permanent forfeiture of her Pennsylvania real estate license. At the guilty plea hearing, Ottenstein reportedly admitted that he falsely billed insurance companies in several ways. Ottenstein reportedly admitted that he billed for certain treatments – treatments used for back injuries commonly claimed by auto accident victims – as surgical back procedures when, in fact, non-surgical, mechanical traction procedures were used. In addition, he reportedly admitted that he billed for use of medical supplies known as sterile trays in connection with epidural injections when, in fact, sterile trays were not used, and that he wrongfully billed for an additional “facility fee” for epidural injections when regulations prohibited billing such fees in the circumstances. Among the insurance companies reportedly falsely billed by Ottenstein were Aetna, AmeriHealth, Health Net, Horizon Blue Cross Blue Shield, MetLife, New Jersey Manufacturers, The Oxford Plan, State Farm and Zurich Insurance. Based on the Office of Insurance Fraud Prosecutor’s investigation, Ottenstein wrongfully billed approximately $477,000 to these companies.
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