Two Chiropractors, an Orthopedist, and a Runner Arrested for Illegal
NEWS RELEASE Prosecutor Camelia M. Valdes Passaic County Prosecutor’s Office 401 Grand Street Paterson, NJ 07505 (973) 881-4800 TWO CHIROPRACTORS, AN ORTHOPEDIST, AND A RUNNER ARRESTED FOR ILLEGAL INSURANCE SCHEME PATERSON, NEW JERSEY: June 4, 2015 Passaic County Prosecutor Camelia M. Valdes announces the arrest of Dr. Kenneth Gross, D.C., age 44, and his wife, Dr. Michelle Dubnoff, D.C., age 45, both of Morganville, New Jersey, Dr. James Morales, M.D., an orthopedist, age 45, of Toms River, New Jersey, and James Hill, age 50, of Hasbrouck Heights, New Jersey. Dr. Kenneth Gross, a chiropractor, ran his practice out of Chiropractic Physicians Group, 293 Passaic Avenue, Passaic, New Jersey. Dr. Gross submitted false billing, false medical and chiropractic notes. Dr. Gross paid James Hill for illegal “running” to refer patients to his practice so that he could treat them and then file claims with their insurance companies. Payments to James Hill were laundered and disguised. James Hill failed to pay New Jersey income tax returns on these funds. Dr. Gross’s wife, Dr. Michelle Dubnoff, a chiropractor, ran her practice out of Ocean Wellness Center, 1868 Hooper Avenue, Toms River, New Jersey, Suite 3. Dr. James Morales, an orthopedist, ran his practice out of Shore Sports Medicine, 1868 Hooper Avenue, Toms River, New Jersey, Suite 5. Dr. Gross, Dr. Dubnoff, and Dr. Morales engaged in an illegal referral scheme, referring patients to and amongst themselves to commit health care claims fraud and to maximize insurance payments. Billing records were submitted by the defendants to various insurance carriers on behalf of Chiropractors Physician Group (Dr. Kenneth Gross), Shore Sports Medicine (Dr. James Morales), and Ocean Wellness Center (Dr. Michelle Dudnoff) that created or reinforced a false impression that said entities were independent of each other and referrals were made on an arm’s length professional basis for the best interest of the patients. In fact, the defendants and corporate entities they controlled are directly related by family and financial interconnection in violation of New Jersey State law. Dr. Kenneth Gross is charged with Illegal Running (3rd degree) (N.J.S.A. 2C:2122.1), Conspiracy to Commit Health Claims Fraud (2nd degree) (N.J.S.A. 2C:5-2/2C:214.3), Commercial Bribery (3rd degree) (N.J.S.A. 2C:21-10), and Health Claims Fraud (2nd degree) (N.J.S.A. 2C:21-4.3). Dr. James Morales is charged with Conspiracy to Commit Health Claims Fraud (2nd degree) (N.J.S.A. 2C:5-2/2C:21-4.3), Commercial Bribery (3rd degree) (N.J.S.A. 2C:2110), and Health Claims Fraud (2nd degree) (N.J.S.A. 2C:21-4.3). Dr. Michelle Dubnoff is charged with Conspiracy to Commit Health Claims Fraud (2 degree) (N.J.S.A. 2C:5-2/2C:21-4.3). nd James Hill is charged with Illegal Running (3rd degree) (N.J.S.A. 2C:21-22.1), Conspiracy to Commit Health Claims Fraud (3rd degree) (N.J.S.A. 2C:5-2/2C:21-4.3), Failure to File Returns (Tax Evasion) (3rd degree) (N.J.S.A. 54:52-8), Failure to Pay (3rd degree) (N.J.S.A. 54:52-9), Money Laundering (2rd degree) (N.J.S.A. 2C:21-25). Third degree crimes are punishable by three to five years in New Jersey State Prison. Second degree crimes are punishable by five to ten years in New Jersey State Prison. Special thanks to Ocean County Prosecutor’s Office, under the leadership of Prosecutor Joseph Coronato, the New Jersey Attorney General’s Office, Office of the Insurance Fraud Prosecutor, under the leadership of Insurance Fraud Prosecutor Ronald Chillemi, the police department of Passaic, Paterson, Toms River and Hasbrouck Heights, and the National Insurance Crime Bureau. The investigation is continuing. Passaic County Chief Assistant Prosecutor Jay W. McCann is prosecuting the case against the defendants, and if you have any questions, he may be reached at (973) 837-7616 or [email protected]. A criminal complaint is merely an accusation. Despite this accusation, the defendants are presumed innocent unless and until proven guilty beyond a reasonable doubt. Dr. James Morales, M.D., 45 Toms River, New Jersey Dr. Michelle Dubnoff, D.C., 45 Morganville, New Jersey Dr. Kenneth Gross, D.C., 44 Morganville, New Jersey James Hill, 50 Hasbrouck Heights, New Jersey
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