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NJ Health Care Claims Fraud, 2C:21-4.3

Health Care Claims Fraud (2C:21-4.3) is becomming one of the most common white collar crimes in New Jersey.  This offense is far reaching as it often ensnares New Jersey doctors, chiropractors, pharmacists in addition to patients.  All health insurance companies employ a large team of investigators to uncover fraud.  In fact one of the larger health insurance providers in New Jersey employs over 20 investigators and that number is expected to increase as health care claims fraud becomes more common.  These investigators generally do not have to worry about Miranda rights so anything you say to them will be used against you.  The good news is that prosecution can be avoided if an attorney can get in the case early enough and work with the investigator to resolve the case.

If you have been arrested for health care claims fraud (2C:21-4.3) or any other fraud offense in New Jersey, if you have been called by the police to give a statement or an insurance company or your employer would like you to explain some charges or accounts, call me to discuss your matter.  I’ll use my experience and dedication to defend you against charges of health care claims fraud or any other fraud charge.  I can represent you against any State or Federal court in New Jersey. 

If you are facing a charge of health care claims fraud (2C:21-4.3) in New Jersey, call me today.

With offices in New Brunswick, Toms River, Eatontown and Princeton, it is easy to meet with me from anywhere in New Jersey.  

  • Health Care Claims Fraud § 2C:21-4.3.a. A practitioner is guilty of a crime of the second degree if that person knowingly commits health care claims fraud in the course of providing professional services. In addition to all other criminal penalties allowed by law, a person convicted under this subsection may be subject to a fine of up to five times the pecuniary benefit obtained or sought to be obtained.b. A practitioner is guilty of a crime of the third degree if that person recklessly commits health care claims fraud in the course of providing professional services. In addition to all other criminal penalties allowed by law, a person convicted under this subsection may be subject to a fine of up to five times the pecuniary benefit obtained or sought to be obtained.

    c. A person, who is not a practitioner subject to the provisions of subsection a. or b. of this section, is guilty of a crime of the third degree if that person knowingly commits health care claims fraud. A person, who is not a practitioner subject to the provisions of subsection a. or b. of this section, is guilty of a crime of the second degree if that person knowingly commits five or more acts of health care claims fraud and the aggregate pecuniary benefit obtained or sought to be obtained is at least $ 1,000. In addition to all other criminal penalties allowed by law, a person convicted under this subsection may be subject to a fine of up to five times the pecuniary benefit obtained or sought to be obtained.

    d. A person, who is not a practitioner subject to the provisions of subsection a. or b. of this section, is guilty of a crime of the fourth degree if that person recklessly commits health care claims fraud. In addition to all other criminal penalties allowed by law, a person convicted under this subsection may be subject to a fine of up to five times the pecuniary benefit obtained or sought to be obtained.

    e. Each act of health care claims fraud shall constitute an additional, separate and distinct offense, except that five or more separate acts may be aggregated for the purpose of establishing liability pursuant to subsection c. of this section. Multiple acts of health care claims fraud which are contained in a single record, bill, claim, application, payment, affidavit, certification or other document shall each constitute an additional, separate and distinct offense for purposes of this section.

    Due to the location of hospitals and other health care facilities in New Jersey, health care claims fraud (2C:21-4.3) is more common in Newark, Trenton, Jersey City, New Brunswick, Paramus, Hackensack.  Regardless of where in New Jersey you have been charged, I will fight for you!

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