East Brunswick dental practice billing manager admits illegally charging ... myCentralJersy.com
Magdy Rafla, 56, the billing manager at his wife's dental practice in East Brunswick, pleaded guilty to the second-degree health care claims fraud charge before Superior Court Judge Frederick P. DeVesa in Middlesex County, according to Acting Insurance Fraud Investigator Riza Dagli. Sentencing was scheduled for Sept. 13.According to the press release, the state will recommend that Rafla be sentenced to three years in state prison and Rafla also signed a consent judgment ordering him to pay a $50,000 civil fine.
As part of the the plea agreement, Ralfa's wife, Gina Tanios-Rafla, has agreed to a five-year dental license suspension, including 364 days of an active suspension with the remainder served as a period of probation, officials said. She also signed a separate consent judgment ordering her to pay a $50,000 civil fine.
In pleading guilty, Rafla admitted that between Feb. 9, 2004 and June 14, 2007 he knowingly falsified the patient dental records of about 66 different patients to include dental services that were not provided and submitted those records to various insurance companies for payment or reimbursement, officials said. An investigation by the Office of the Insurance Fraud Prosecutor determined that, as a result of the fraud, Rafla's wife's dental practice received $45,000 for the dental services not performed, officials said.
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