A New Jersey 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.
Dr. Todd Koppel, a New York City resident who ran Garden State Pain Management ("GSPM") in Clifton, New Jersey, 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.
According to prosecutors, three of those chiropractors have admitted to participating in the scheme and accepting kickbacks from Dr. Koppel.
According to the indictment, over a 10-year span Dr. 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 allegedly fraudulent claims, Dr. Koppel omitted the material fact that the treatments were the result of an illegal kickback scheme, prosecutors said.
Dr. Koppel received more than $500,000 in insurance payments from his activities, which were deposited into GSPM's business accounts and later moved to his personal bank accounts, according to the indictment.
Dr. Koppel allegedly used some of the proceeds to generate cash to pay additional kickbacks.
"Medical kickback schemes like this are a form of insurance fraud that spreads like a cancer throughout the healthcare industry, putting more and more unsuspecting patients into the hands of doctors who use them as cash cows to drive up billable services," said Acting New Jersey Insurance Fraud Prosecutor Christopher Iu.
Prosecutors said that the three chiropractors who admitted receiving kickbacks from Dr. Koppel were:
- Phillip Potacco, former operator of the South Orange Trauma and Rehab Center in South Orange, who pleaded guilty in a kickback scheme involving the center.
- Ronald Hayek, former operator of Union Wellness Center in Totowa, who pleaded guilty in a kickback scheme involving medical imaging centers in North Jersey.
- 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, Dr. 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)
Steven A. Meyerowitz
Steven A. Meyerowitz, a Harvard Law School graduate, is the founder and president of Meyerowitz Communications Inc., a law firm marketing communications consulting company. He may be contacted at [email protected].