Insurance fraud nets former doctor, again

Published: 2011-07-20 10:13:33
Author: Michael P. Mayko

  Federal authorities Tuesday pulled the wraps off a four-year long scam they say enriched a local attorney, chiropractor and doctor and cost the state and insurance companies tens of thousands of dollars.

Francisco R. Carbone, of Fairfield, a 53-year-old former doctor, became the second person convicted in the case when he pleaded guilty to two federal charges of conspiring to commit mail fraud, as well as single charges of conspiring to distribute narcotic substances and making a false statement related to health care.


Earlier this year, Dr. James W. Marshall, who operates Immediate Medical Care on Main Street in Monroe, admitted that, at Carbone's request, he illegally wrote prescriptions for narcotic painkillers to patients he had never seen. Marshall, who wrote 145 prescriptions for more than 4,400 pills, faces up to 30 months in prison when sentenced.


Both Carbone and Marshall are cooperating with the investigation.


Carbone, whose license was suspended by the state for five years after he pleaded guilty to Medicare fraud in 1998, then pulled in 2005 after he was implicated in another FBI health care probe, faces up to 71 months in prison when he is sentenced on these charges by U.S. District Judge Stefan R. Underhill.

Assistant U.S. Attorney Christopher Schmeisser said the fraud, which ran from December 2006 to February 2010, involved Carbone, the attorney and the chiropractor agreeing to exaggerate the extent of injuries to their clients, performing unnecessary treatment and diagnostic testing and prescribing narcotic painkillers in an effort to increase the eventual settlement paid out by insurance companies.