2 NJ Doctors Penalized For $2M In Medicare Fraud: Authorities

NEW JERSEY — The New Jersey Board of Medical Examiners has permanently revoked the license of one doctor and suspended the license of another, both of whom admitted to defrauding Medicare and other healthcare insurers out of nearly $2 million combined.

The board revoked the license of 69-year-old Robert Claude McGrath, of Mays Landing, Attorney General Gurbir S. Grewal and the Division of Consumer Affairs announced on Tuesday. At the same time, it has suspended the license of 46-year-old Michael E. Goldis, of Mount Laurel, relating to a separate incident of medicare fraud.

“Health care fraud is a serious crime that results in reduced benefits and higher costs for coverage,” Grewal said. “Annual losses to fraudulent health insurance claims are estimated at billions of dollars that eventually come out of everyone’s pockets. We will continue to enforce the laws in place to protect New Jersey consumers and the integrity of the entire medical profession.”

McGrath previously admitted to employing unqualified individuals to provide physical therapy to patients, according to authorities. He also collected $890,000 in payments that he was not entitled to, authorities said.

McGrath and his son, Christopher McGrath, participated in the scheme together, authorities said. They each pleaded guilty to separate informations charging them each with conspiracy to commit health care fraud, and the father was sentenced to two years, six months in prison. He was released in May, authorities said. Read more here: Cherry Hill Doctor, Son Sentenced For Medicare Fraud

Atlantic Spine & Joint Institute is a medical practice with offices in Haddon Township, NJ, and Wayne, Pa., according to documents filed in the case and statements made in court. Under Medicare rules, physical therapy had to be provided by Robert Claude McGrath or by a trained physical therapist under his supervision.

However, the McGraths admitted that from January 2011 through April 2016, they employed unlicensed, untrained persons to give physical therapy to Medicare patients, at times when Robert Claude McGrath was not even in the office to supervise, according to authorities. They then submitted bills to Medicare fraudulently identifying Robert Claude McGrath as the provider of physical therapy. Read more here: Cherry Hill Doctor, Son Admit To Medicare Fraud, Authorities Say

Under the terms of the order filed on Oct. 12, McGrath is not allowed to enter his medical practice when patients may be present. He is also barred from managing, overseeing, supervising or influencing the practice of medicine in New Jersey. His license to prescribed controlled substances is permanently revoked, and he isn’t permitted to ever seek a medical license or CDS registration in New Jersey again.

Goldis, who owns Goldis Primary Care and Geriatrics in Stratford, previously pleaded guilt to making false statements relating to health care matters, according to authorities.

He admitted that he signed prescriptions for individuals with whom he did not have a doctor-patient relationship, and then billed health insurance providers for unnecessary costly compounded medications.

Authorities said Goldis signed prescriptions stating he had reviewed patients’ records, determined that compounded medications were medically necessary, and verified he had face to face examinations with patients he had not actually seen or evaluated.

He admitted lying about these matters, resulting in losses of at least $992,326.62, authorities said. At the time he was accused, of was one of four doctors who were charged in the conspiracy. Read more here: Trenton Doctor From Bordentown Admits To Healthcare Fraud: FBI

He agreed to the suspension of his license to practice in New Jersey on Oct. 30 to avoid a complaint by the Attorney General’s Office. The suspension will remain in effect until and unless the board orders otherwise, authorities said.

While his license is suspended, Goldis can’t manage, oversee, supervise or influence the practice of medicine in New Jersey, and he can’t enter his former medical practice when patients may be present.

“Dishonest providers who abandon their ethical standards and violate the law for personal enrichment cause serious harm to the profession and undermine our healthcare system,” said Paul R. Rodríguez, Acting Director of the Division of Consumer Affairs. “By holding these individuals accountable for their actions, we are looking out for the public’s well-being and restoring trust in the institutions responsible for ensuring their safety.”