N.J. Doctor Sentenced to Two Years in Prison for Health Care Fraud

NEWARK, N.J. – Dr. Michael P. Stein, 63, a New Jersey doctor, was sentenced today to 24 months in prison for defrauding Blue Cross Blue Shield for approximately three-quarters of a million dollars by submitting false claims for services never performed.
Between August 2004 and September 2010 Stein owned and operated Randolph Otolaryngology. Stein purportedly treated a patient with the initials J.F. for nasal problems and billed Blue Cross Blue Shield for the services.
However, investigators determined that Stein submitted fraudulent claims with Blue Cross Blue Shield for procedures that were not performed. Evidence revealed that Stein submitted claims for approximately 900 nasal endoscopies he purportedly conducted, when only a few were actually performed. Stein also admitted he filed false claims for office visits and medical procedures that occurred while he was out of the country on vacation.
Blue Cross Blue Shield paid Stein $725,156.45 from as a result of the fraudulent false claims submitted, and, under the plea agreement, Stein agreed to pay restitution and forfeiture for the entire amount.
In addition to the prison term, restitution and forfeiture, Stein was ordered to serve three years of supervised release. His medical license has been surrendered.

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