Benjamin Sabido, Health Care Fraud, New Jersey 2015

A Newark doctor has admitted to a three-year scheme to bill Medicare for physical therapy services that were not provided.

Benjamin Sabido, 62, of Franklin Lakes, N.J., pleaded guilty before U.S. District Judge Claire C. Cecchi in Newark federal court to an information charging him with health care fraud. The count of health care fraud to which Sabido pleaded guilty carries a maximum potential penalty of 10 years in prison and a $250,000 fine, or twice the gain or loss caused by the offense.

Sentencing is scheduled for May 14, 2015.

Sabido received $237,182 from Medicare and Medicaid based upon fraudulent claims. He instructed staff to submit bills for physical therapy services that were not in fact provided. He authorized and encouraged unqualified staff members to provide physical therapy services, including electrical stimulation, massage, and other therapeutic services. During the time period of the scheme, Sabido did not employ any licensed physical therapists, nor anyone otherwise qualified to provide physical therapy services.

The government is represented in the criminal case by Assistant U.S. Attorney Joseph Mack, Deputy Chief of the U.S. Attorney’s Office’s Health Care and Government Fraud Unit, and in the civil settlement by Assistant U.S. Attorney Charles Graybow of the Health Care and Government Fraud Unit.

Sabido will pay $700,545, plus interest, to resolve allegations arising from Sabido’s submission of claims for physical therapy and nerve conduction studies. From December 2006 to December 2010, Sabido submitted to Medicare and Medicaid claims for physical therapy services that were rendered because the patients wanted these services and not necessarily because they benefited from them, were not provided pursuant to a plan of care, were not properly supervised, or were not provided by qualified personnel.

The government has recovered over $625 million in health care fraud and government fraud settlements, judgments, fines, restitution and forfeiture under the False Claims Act, the Federal Food, Drug and Cosmetic Act and other statutes since 2010.

Source: https://www.justice.gov/usao-nj/pr/physician-admits-billing-medicare-and-medicaid-phantom-physical-therapy-services