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TOMS RIVER – After an undercover law-enforcement officer went to a Beachwood chiropractor for treatment last year, authorities investigating the health care provider learned he billed an insurance company for four more visits than actually occurred, a prosecutor said.
But that was the tip of the iceberg, according to a recent indictment.
Following further investigation, authorities allege the chiropractor, Carlo Amato, overbilled insurance companies about $1 million for treatment he never provided to patients and then tried to hide the proceeds in various bank accounts, including one in Russia, said Martin Anton, supervising assistant Ocean County prosecutor.
Amato, who was originally arrested in December, was charged in a recent indictment with 15 crimes that could land him in prison for decades, if he is convicted of them.
They include insurance fraud, four counts of health care claims fraud, seven counts of theft by deception, two counts of money laundering, and one count of possessing a controlled dangerous substance – fentanyl, an often deadly synthetic opioid.
The health care claims fraud charges allege that Amato submitted bills to Metropolitan Life Insurance for payment for four office visits by the undercover officer, who didn’t go for treatment on those dates, Anton said. Amato also was charged with theft by deception of more than $500 he derived from that insurance company from payments for the phantom visits, according to Anton.
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The indictment charges Amato with theft by deception of more than $75,000 from each of six other insurance companies for receiving payment for treatment that was never provided, Anton said. The companies that were said to be defrauded were GEICO, Progressive Casualty Insurance Co., Plymouth Rock Assurance Co., New Jersey Manufacturers Insurance Co., American Automobile Association Co. and Cure Auto Insurance Co.
The assistant prosecutor said a review of records revealed that while the patients for whom claims were submitted were legitimate, they either didn’t visit Amato’s office on the stated dates, or the days Amato said the office visits occurred were on dates he was on vacation.
“He couldn’t have provided the treatment because either he wasn’t there or (the patients) weren’t there,’’ Anton said.
“Almost all of his patients were auto accident victims covered by personal injury protection under their (auto insurance) policies,’’ Anton said.
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Further investigation revealed Amato tried to hide the proceeds of the alleged scheme by transferring it from his business bank accounts to other accounts and ultimately to a bank in Russia, Anton said.
Despite that, authorities were able to seize $1.5 million from his bank accounts here, the assistant prosecutor said.
Amato is free on $150,000 bail. He voluntarily surrendered his chiropractic license following his arrest last year, Anton said.
Amato will face an arraignment on the charges within the next several months.
Kathleen Hopkins: (732)643-4202; Khopkins@app.com
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