N.J. Medical Office Manager Pleads Guilty to Aiding Doctor in Fraud Scam

New Jersey Attorney General Peter Harvey announced that the office manager of a Passaic County medical practice has pleaded guilty to submitting more than $8,000 in phony health care insurance claims and/or billings for medical services that were reportedly never rendered to patients. The fraudulent claims were submitted to at least two insurance companies.

According to Vaughn McKoy, Director, Division of Criminal Justice and Insurance Fraud Prosecutor Greta Gooden Brown, Mercy Lobo, 61, of Passaic County, plead guilty before Passaic County Superior Court Judge Miguel A. de la Carrera to a charge of Health Care Claims Fraud. Lobo faces up to five years in state prison, a fine of up to $15,000, restitution, and a potential civil insurance fraud fine. Lobo is scheduled to appear before Judge de la Carrera on Jan. 23, 2004 to be sentenced.

Gooden Brown noted that Lobo was charged via a State Grand Jury indictment returned on Oct. 30, 2001. The indictment charged her with conspiracy, Health Care Claims Fraud, criminal use of runners, theft by deception, and attempted theft by deception. The State Grand Jury indictment also charged Angel Lobo, M.D. (no relation), 71, Garden City, NY, with conspiracy, Health Care Claims Fraud, criminal use of runners, theft by deception and attempted theft by deception. Dr. Lobo, licensed to practice medicine in New Jersey since 1974, was the owner/operator of The Pain Management Clinic located on 14th Street in Paterson. Dr. Lobo was arrested by state investigators assigned to the Division of Criminal Justice – Office of Insurance Fraud Prosecutor on June 12, 2001. Mercy Lobo was arrested on July 16, 2001.

In pleading guilty, Mercy Lobo reportedly admitted that she assisted Dr. Lobo in obtaining, using and paying “runners” to secure patients for the medical practice.

At the guilty plea hearing, Lobo is reported to have admitted that she submitted more than $6,400 in false automobile insurance Personal Injury Protection (PIP) health care claim billings to the Parkway Insurance Company and more than $2,150 in fraudulent billings to AIG Claims Services, Inc. Additionally, Lobo reportedly admitted instructing at least one patient to sign-in at The Pain Management Clinic on dates that the patient did not appear for treatment.

On Sept. 11, Dr. Lobo pleaded guilty to Health Care Claims Fraud and is scheduled to be sentenced by Judge de la Carrera on Jan. 14, 2004.