the staff of the Ridgewood blog
Newark NJ, Acting Attorney General Matthew J. Platkin and the Office of the Insurance Fraud Prosecutor today announced the arrest of a Newark doctor on charges of forgery, obtaining a controlled dangerous substance by fraud, and health care claims fraud. The arrest was the result of an investigation by the Office of the Insurance Fraud Prosecutor’s Medicaid Fraud Control Unit.
Sagy Grinberg, 39, of Weehawken, N.J., was arrested on Friday, April 1 and charged with the following:
- Health care claims fraud (2nd degree);
- Forgery (two counts, 3rd degree);
- Obtaining Xanax by fraud (3rd degree);
- Obtaining Oxycodone/Percocet by fraud (3rd degree);
- Obtaining D-Amphetamine by fraud (3rd degree);
- Obtaining Adderall by fraud (3rd degree); and
- Obtaining Promethazine/Codeine by fraud (3rd degree).
On or about March 19, 2021, Walgreens Pharmacy in Vauxhall, N.J., notified a New Jersey doctor that they were in possession of 12 prescriptions allegedly written by the doctor for Grinberg. The doctor informed Walgreens that he neither wrote nor verbally authorized the prescriptions. 13 alleged fraudulent prescriptions (primarily for Percocet) were identified as prescribed by this doctor and a second doctor between October 18, 2019 and February 20, 2021.
During an interview with the second doctor on September 23, 2021, the doctor advised that he and Grinberg previously worked together at Newark Beth Israel Medical Center (NBIMC) as residents. This doctor confirmed that Grinberg was never his patient and he never wrote prescriptions for Grinberg. The doctor also confirmed that the signature on the prescription was not his.
The investigation revealed that Grinberg’s alleged scheme resulted in the issuance of 69 fraudulent prescriptions for about 141 drugs between January 27, 2016 and February 20, 2021. The alleged scheme included the following controlled dangerous substances: Oxycodone, Xanax, D-Amphetamine, Adderall, Promethazine-Codeine, and other pharmaceutical drugs Cialis/Tadalafil, Dexilant, and Dronabinol. Additionally, records revealed Grinberg’s insurance company paid over $6,000 for the fraudulent prescriptions through his benefits plan.
Detective Regina Strugala was the lead detective for the investigation for the Office of the Insurance Fraud Prosecutor’s Medicaid Fraud Control Unit, under the supervision of Sgt. Danielle Han, Lieutenant Jarek Pyrzanowski, Deputy Chief Rich King and Chief Weldon Powell. Deputy Attorney General Lawrence Krayn is prosecuting the case for the Office of the Insurance Fraud Prosecutor, under the supervision of Deputy Bureau Chief Michael Klein, Bureau Chief Peter Sepulveda, and Deputy Insurance Fraud Prosecutor Al Garcia.
Second-degree healthcare claims fraud carries a maximum sentence of 5 to 10 years in state prison and a fine of up to $150,000. The third-degree forgery charges carry a maximum sentence of 3 to 5 years in state prison and a fine of up to $15,000. The third-degree drug charges carry a maximum sentence of 3 to 5 years in state prison and a fine of up to $50,000.
The charges are merely accusations and the defendant is presumed innocent until proven guilty.
New Jersey’s Medicaid Fraud Control Unit receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling approximately $4.1 million for Federal fiscal year (“FY”) 2022. The remaining 25 percent, totaling approximately $1.3 million for FY 2022, is funded by New Jersey.
Insurance Fraud Prosecutor Tracy M. Thompson noted that many 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 website at www.NJInsurancefraud.org. State regulations permit a reward to be paid to an eligible person who provides information that leads to an arrest, prosecution, and conviction for insurance fraud.