State Attorney: Ocean County Pair Billed Blue Cross For $172,000 In Treatments Not Performed

Posted by on May 26, 2016 in | 0 comments

Scam Wire Forum Forums USA – North East Individuals State Attorney: Ocean County Pair Billed Blue Cross For $172,000 In Treatments Not Performed

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    The Provocateur

    An unlicensed former doctor and her husband have been indicted on charges they billed a medical insurance company for more than $172,000 for treatments that were not given to patients, the state attorney general’s office announced Thursday.

    Lynda Stambaugh-Lupo, 52, and Michael Lupo, 61, both of Jackson, were indicted Wednesday by a state grand jury on charges of second-degree conspiracy, second-degree health care claims fraud and second-degree theft by deception.

    Stambaugh-Lupo was also charged with third-degree practice of medicine by an unlicensed person, according to a news release from the office of Acting Attorney General John J. Hoffman and the Office of the Insurance Fraud Prosecutor.

    Stambaugh-Lupo, a former osteopathic doctor, surrendered her medical license in 1996 as the result of being arrested on charges of obtaining a controlled dangerous substance by fraud, the release said.

    In a lengthy YouTube video posted in November 2014, Stambaugh-Lupo claims she has been the target of an ongoing campaign of harassment by the state Board of Medical Examiners for 20 years. The video is more than an hour long. You can watch it below.

    But state prosecutors say that from 2012 to 2014, she and her husband billed Anthem Blue Cross and Blue Shield approximately $172,626 for lymphatic therapy on two patients, therapy that Stambaugh-Lupo had not actually performed. The couple allegedly billed her lymphatic therapy services through their company In Home Lymphatic Care, LLC, for which Michael was office manager and signee on the allegedly fraudulent claims.

    Prosecutors also say Stambaugh-Lupo represented to another patient and the patient’s medical insurer that she was a medical doctor. These representations were allegedly made over the phone or directly to the patient at her home and to the insurer in letters in 2010 and 2011 that laid out the suggested course of treatment for the patient, prosecutors say.

    “The defendants have allegedly perpetrated a theft worth tens of thousands of dollars by lying to medical insurers,” Hoffman said in the news release. “Our charges show a clear pattern of deceitful behavior by this couple, exemplified by Stambaugh-Lupo’s misrepresentations that she was a licensed doctor.”

    Second-degree crimes carry a maximum sentence of 10 years in state prison and a criminal fine of up to $150,000, while third-degree crimes carry a maximum sentence of five years in prison and a fine of up to $15,000.

    Deputy Attorney General Thomas Tresansky presented the case to the grand jury.

    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 by visiting the state’s insurance fraud website, 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.

    Link to original article…

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