New Jersey Attorney General Peter Harvey announced that a Passaic County electrologist has been sentenced to state prison and ordered to pay restitution for attempting to bilk several New Jersey insurance companies out of more than $900,000 in reimbursement payments by billing common electrolysis as a medically necessary cosmetic procedure – a procedure the electrologist was unable to perform.
According to Vaughn McKoy, director, Division of Criminal Justice and Greta Gooden Brown, Insurance Fraud Prosecutor, Florence Acquaire, 64, of Wayne, was sentenced on Sept. 30 by Passaic County Superior Court Judge Randolph Subryan to seven years in state prison and ordered to pay nearly $70,000 in restitution to the Aetna and United Health Care Insurance Companies.
Brown noted that Acquaire was convicted on April 14 by Judge Subryan following a 10-day bench trial. Acquaire, who operated the High Mountain Medical Center, 342 Hamburg Pike, Wayne, was convicted of Health Care Claims Fraud, theft by deception, and attempted theft by deception.
In finding Acquaire guilty, Judge Subryan determined that from July 25, 1998 through April 12, 2001, Acquaire submitted dozens of fraudulent health insurance claims seeking more than $908,843 in reimbursement payments from the United Health Group Insurance Company and the Aetna Insurance Company. The Aetna Insurance Company was billed $843,797, while United Health Group Insurance Company was billed $38,120.
A six-count State Grand Jury indictment returned on Oct. 30, 2003, alleged that Acquaire fraudulently billed electrolysis as a surgical debridement procedure – a medically necessary procedure which involves the surgical excision of dead skin and which must be performed by a doctor or other licensed medical service provider.
Acquaire is reportedly not a licensed medical service provider and was, therefore, not qualified to perform debridement or other surgical procedures and was ineligible to bill insurance companies the higher cost of the surgical procedure.
Was this article valuable?
Here are more articles you may enjoy.