A doctor with offices in Paterson, Passaic, and Elizabeth, New Jersey, has been sentenced to 36 months in prison for defrauding private insurance companies and Medicare out of $3 million by billing them for over 150,000 physical therapy sessions that were performed by unlicensed and unqualified personnel.
Anthony J. Enrico 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 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 such as Enrico who met certain criteria based on training and certifications.
Enrico admitted, however, 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.
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].