North Jersey Physician Sentenced to Federal Prison for Insurance Fraud

Photo Credit NorthJersey.com

NEWARK – The New Jersey Board of Medical Examiners has revoked the license of a family physician with offices in Bergen and Passaic counties after he was sentenced to more than three years in federal prison for bilking $280,000 from Medicaid, Medicare, and various private insurers for services he did not provide.

Albert Ades, 61, of Englewood, agreed to forfeit his license to practice medicine in a Consent Order signed days after his March 14th sentencing in Newark Federal Court. Ades pleaded guilty last year to a single count of health care fraud in connection with a nine-year scheme in which he billed public and private insurers for non-existent office visits to his practices in Cresskill and Little Falls.

“Physicians have a duty to respect the sanctity of their positions and all the responsibilities that come with it. Albert Ades instead chose to abuse his professional standing by stealing from insurers who trusted his integrity,” said Acting Attorney General Robert Lougy. “What makes his crime particularly reprehensible is that he stole from Medicaid, a program designed to assist persons who cannot afford health insurance or health care services.”

Ades admitted that from 2005 through June 2014, he submitted claims for face-to-face office visits on dates when he had authorized prescriptions, written refills, or performed other tasks for patients without seeing them in person. He also admitted that he altered patients’ medical charts by inserting fabricated blood pressure readings, other vitals, and clinical notes on patients’ charts to make it appear as if they had visited Ades’s office on the billed dates.

“For nearly a decade Albert Ades used his medical license as a license to steal from insurance companies,” said Steve Lee, Acting Director of the New Jersey Division of Consumer Affairs. “By revoking his license, the Board of Medical Examiners has made it clear that it will not tolerate doctors who put their own greed above their patients, their profession, and the law.”

Under the terms of the Consent Order with the Board of Medical Examiners, Ades is prohibited from reapplying for his license. Under the criminal sentence handed down in federal court, Ades must serve 37 months in federal prison, and make restitution of $280,000 to more than a dozen private insurance companies and the federal government. He is also subject to three years of supervised release.

Senior Deputy Attorney General Jeri Warhaftig of the Professional Boards Prosecution Section represented the State Board of Medical Examiners in this action.

Consumers who believe they have been cheated or scammed by a business, or suspect any other form of consumer abuse, can file a complaint with the State Division of Consumer Affairs by visiting its website or by calling 1-800-242-5846 (toll free within New Jersey) or 973-504-6200.

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