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Doctor with Offices in Paterson, Elizabeth, Passaic Sentenced for $3M Insurance Fraud

Paterson Passaic Elizabeth

A doctor with offices in Paterson, Passaic, and Elizabeth was sentenced today to 36 months in prison for defrauding Medicare and private insurance companies out of $3 million by billing them for over 150,000 physical therapy sessions that were performed by unlicensed and unqualified personnel, U.S. Attorney Craig Carpenito announced.

According to authorities, Anthony J. Enrico, 60, of North Haledon, previously pleaded guilty before U.S. District Judge Kevin McNulty to an information charging him with one count of health care fraud. Judge McNulty imposed the sentence today in Newark federal court.

According to the documents filed in the case and statements made in court:

From January 2007 through May 2016, Enrico billed Medicare and other health insurance providers for physical therapy services that he supposedly provided to his patients. In order for them to be reimbursable, Medicare and private insurers required that physical therapy services be performed only by individuals like Enrico who met certain criteria based on training and certifications.

Officials said Enrico admitted that on more than 150,000 occasions, those services were performed at his direction by individuals who lacked the necessary training and certifications, resulting in him fraudulently obtaining approximately $3 million from Medicare and private insurers.

In addition to the prison term, Judge McNulty sentenced Enrico to three years of supervised release and ordered him to pay restitution of $3 million.

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