TRENTON – Attorney General Gurbir S. Grewal and the Office of the Insurance Fraud Prosecutor (“OIFP”) announced that a Bergen County family practitioner is facing five years in prison for submitting more than $32,000 in false claims to an insurance company for health care services he never rendered.
Dr. Robert Delagente, 45, of Oakland, who practiced at North Jersey Family Medicine, pleaded guilty to a one-count accusation charging him with second-degree health care claims fraud. Under the terms of the plea agreement, the State will recommend that Delagente be sentenced to five years in prison. Delagente is scheduled to be sentenced on January 10, 2020.
In pleading guilty before Superior Court Judge James X. Sattely in Bergen County on Nov. 21, 2019, Delagente admitted that between May and December of 2016 he submitted seven fraudulent claims to Blue Cross/Blue Shield of New Jersey totaling $32,006.
The fraudulent claims billed the insurance company for allergy testing and immunotherapy services that Delagente did not provide to patients.
“When doctors cheat the insurance system, they’re committing a crime that drives up the cost of healthcare for everyone, including the patients they took an oath to serve,” said Attorney General Grewal. “The five-year prison sentence this doctor faces sends a message that New Jersey will not tolerate medical providers who abuse their professional authority for illegal gain.”
“Insurance fraud costs insurance companies billions of dollars every year nationwide and those losses are passed on to all of us through higher insurance premiums and increased costs for goods and services,” said Acting Insurance Fraud Prosecutor Tracy M. Thompson. “To protect New Jersey residents from being victimized by insurance cheats we will continue to pursue harsh punishments like the one announced to send a strong message of deterrence.”
Deputy Attorney General Crystal Callahan represented the State during the plea hearing.
Delagente was charged following a joint investigation of his practice by OIFP and the FBI. The investigation was coordinated by OIFP Detectives Suzanna Lopez and Janet Thai, and special agents with the FBI Health Care Fraud Unit.
Delagente also faces criminal charges in federal court stemming from this investigation.
On May 13, 2019, the U.S. Attorney’s Office of the District of New Jersey charged Delagente with one count of distribution of controlled dangerous substances for allegedly prescribing opioid pain medications and other controlled substances outside the ordinary course of professional practice, and one count of obstruction of justice for allegedly falsifying medical records to cover it up.
In the wake of the federal charges against him, Delagente entered an Interim Consent Order with the State Board of Medical Examiners in which he agreed to the temporary suspension of his license pending the outcome of those charges and pending further action by the Board.
Acting Insurance Fraud Prosecutor Thompson noted that some important cases have started with anonymous tips. People who are concerned about insurance cheating and have information about a fraud can report it anonymously by calling the toll-free hotline at 1-877-55-FRAUD, or visiting the Web site at www.njinsurancefraud.org. State regulations permit a reward to be paid to an eligible person who provides information that leads to a conviction for insurance fraud.