What Happened

The healthcare fraud enforcement efforts of the U.S. Attorney’s Office for the District of New Jersey continue. Anthony J. Enrico, 60, of North Haledon, New Jersey pleaded guilty on October 17, 2017 to an information charging him with health care fraud. Enrico admittedly billed Medicare and other health insurance providers for physical therapy services that he had reported to have performed on his patients’ between January 2007 and May 2016.

The Rundown

Enrico billed Medicare and private insurance companies for physical therapies he did not perform or were performed by individuals that were uncertified or unlicensed on more than 150,000 occasions. As a result, he managed to collect close to $3 million from the government and private insurance companies alike, which ultimately gained the attention of the Health Care and Government Fraud Unit, the department of Health and Human Services, and the FBI. Enrico faces a maximum penalty of 10 years in prison, a fine of up to twice the amount of the loss, as well as payment for restitution totaling $3 million. His sentencing will take place on January 25, 2018.

The Take Home

The Health Care and Government Fraud Unit of the U.S. Attorney’s Office for the District of New Jersey has been working diligently since 2010 to crackdown on health care fraud throughout the state. Created by the U.S. Attorney’s Office for the District of New Jersey to handle both criminal and civil investigations and prosecutions of health care fraud offenses, they have recovered more than $1.36 billion in various health care and government fraud settlements, judgments, fines, restitution and forfeiture under the False Claims Act, the Food, Drug and Cosmetic Act, and other statutes. There are no signs of its aggressive enforcement efforts letting up.