NJ: Monmouth County Man Charged With Submitting Fraudulent Health Insurance Claims in the Name of the Doctor He Worked For, Then Stealing the Insurance Checks When the Claims Were Paid

Attorney General Christopher S. Porrino and the Office of the Insurance Fraud Prosecutor (OIFP) announced that a Monmouth County man was charged today with submitting fraudulent health insurance claims in the name of the ophthalmologist he worked for, then stealing the insurance checks when they came into the doctor’s office.

Austin B. Mongiello, 27, of Manalapan, was indicted by the State Grand Jury on charges of second-degree health care claims fraud, third-degree theft by deception, third-degree theft by unlawful taking, and fourth-degree forgery.

“Defrauding an insurance carrier and stealing from your boss is not a way to make easy money in New Jersey, it’s a way to get yourself locked up,” said Attorney General Porrino. “We will not tolerate anyone who puts their own greed above the law, as we alleged Austin Mongiello has done.”

“Individuals working in doctors’ offices are expected to respect the integrity of the insurance process, not exploit it for their own gain,” said Acting Insurance Fraud Prosecutor Christopher Iu. “Those who do so will face serious consequences.”

According to the indictment, between September 1, 2012 and March 30, 2013, Mongiello submitted $4,155 in fraudulent health insurance claims to VSP, an insurance carrier specializing in vision care. He allegedly submitted the claims under the name of his employer, an ophthalmologist with a practice in Belleville.

VSP issued checks amounting to $1,456 to the ophthalmologist, but Mongiello was only able to steal $842 worth of VSP checks from the doctor’s office. According to the prosecutor, Mongiello was also charged with stealing $687.28 in checks made payable to his employer by Davis Vision, IPA, another insurance carrier specializing in vision care.

The indictment is merely an accusation and defendants are presumed innocent until proven guilty. Second-degree crimes carry a sentence of five to ten years in state prison and a criminal fine of up to $150,000; third-degree crimes carry a sentence of three to five years in state prison and a criminal fine of up to $15,000; fourth-degree crimes carry a sentence of up to eighteen months in state prison and a criminal fine of up to $5,000.

Deputy Attorney General Thomas G. Tresansky, Jr. presented the case to the grand jury. Detectives Eric Flickinger and Brian Bunn coordinated the investigation with assistance from Analyst Marie Beyer.

Acting Insurance Fraud Prosecutor Iu noted that some important cases have started with anonymous tips. People who are concerned about insurance cheating and have information about a fraud can report it anonymously by calling the toll-free hotline at 1-877-55-FRAUD, or visiting the Web site at www.NJInsurancefraud.org. State regulations permit a reward to be paid to an eligible person who provides information that leads to an arrest, prosecution and conviction for insurance fraud.

SOURCE: NJ Attorney General’s Office

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