Owner of N.J. Medical Companies Charged with Insurance Fraud

New Jersey Attorney General Peter Harvey announced that a Camden County businessman who owns and operates a chiropractic clinic and two medical service and supply companies has been charged by the Division of Criminal Justice – Office of Insurance Fraud Prosecutor with concocting a multi-corporation conspiracy designed to bilk insurance companies out of thousands of dollars through the submission of fraudulent claims for medical services and supplies provided to accident victims — patients often secured by the use of “runners.”

According to Vaughn McKoy, director, Division of Criminal Justice and Insurance Fraud Prosecutor Greta Gooden Brown, Orlando Rolon, 49, of Runnemede and his purported girlfriend Erika Ramos, 31, of Pennsauken, Camden County, were charged via a State Grand Jury indictment with conspiracy, Criminal Use of Runners, Health Care Claims Fraud, attempted theft by deception, and misconduct by a corporate official. The indictment also charged Ramos with two counts of uttering a forged document.

Second degree crimes carry a maximum penalty of up to ten years in state prison and a fine of up to $150,000. A third degree crime carries a maximum penalty of up to five years in state prison and a fine of up to $15,000, while a fourth degree crime carries a maximum penalty of up to 18 months in state prison and a fine of up to $10,000. The defendants also face possible civil insurance fraud fines pursuant to the Insurance Fraud Prevention Act.

According to Brown, the indictment alleges that between Dec. 11, 1998 and Feb. 13, 2002, Rolon and Ramos participated in a conspiracy to fraudulently bill insurance companies nearly $135,000 for medical treatments, supplies, and transportation services provided to patients injured in automobile accidents. It is charged that Rolon created a system of companies that provided medical treatments, supplies, and transportation services.

The Rolon-owned companies are identified as Camden County-based Brotherhood Rehabilitation Associates P.C., a chiropractic treatment center located at 3422 Westfield Ave. (business offices located at 145 N. 34th St., Camden); JOL&M Medical Supply Company, 1099 Route 73 South, Berlin; and OR Medical Transport, 145 N. 34th St., Camden.

The indictment alleges that Rolon, who had no medical or chiropractic license, created the appearance that a licensed chiropractor actually owned, operated and controlled the Brotherhood clinic in order to submit insurance claims for payment. It is alleged that Ramos, employed at the Brotherhood clinic, was listed as the owner/operator of JOL&M Medical Supply so that it would appear to insurance companies that JOL&M Medical Supply was independent from the Brotherhood, when, in fact, the company was owned, operated, and controlled by Rolon.

The indictment charges that Rolon used “runners” to solicit accident victims in order to ensure a steady stream of patients for the Brotherhood clinic which provided chiropractic treatments, physical therapy, and other medical services to patients injured in automobile accidents. As part of the insurance fraud, it is alleged that Rolon listed chiropractor Dr. Michael Marek as the owner of the clinic and that Marek made medical decisions with respect to Brotherhood patients and signed claims forms submitted to the insurance companies when, in fact, Marek was deceased.

Additionally, it is charged that Rolon and the “runners” attracted patients to the Brotherhood clinic by offering payments of between $200 to $300. It is also alleged that some of the patients solicited by the “runners” purchased medical supplies (such as TENS Units used to treat soft tissue injuries of persons injured in auto accidents) from JOL&M Medical Supply Company as part of their treatment and that OR Medical Transport was used to transport patients to and from the Brotherhood clinic and other Rolon-controlled locations.

In addition to the criminal use of runners, it is alleged that Rolon and Ramos committed Health Care Claims Fraud by submitting false claims to Liberty Mutual and AIG Insurance Companies. The investigation determined that the Brotherhood clinic billed Liberty Mutual Insurance Company and AIG Insurance Company approximately $134,922 for automobile insurance PIP claims. The companies paid the Brotherhood $32,956.

The indictment was handed up to Mercer County Superior Court Judge Linda Feinberg, the assignment judge in charge of the State Grand Jury, on Dec. 2. The case will be assigned to Camden County Superior Court for trial. The defendants will be ordered to appear in Court to answer the charges on a date to be determined.