Plattsburgh native Scott Newcombe, aged 41, has had his legal reckoning, being sentenced on health care fraud charges. He now faces a year of probation and a restitution bill amounting to $34,583.21. This resolution was the outcome as announced by Acting United States Attorney Daniel Hanlon, joined by authorities including Albany's office FBI Special Agent Craig L. Tremaroli and Naomi Gruchacz of the HHS-OIG New York Regional Office, according to a press release by the U.S. Attorney's Office.
It seems Newcombe's misdeeds spanned a significant timeline, beginning around April 2020 and persisting until April 2023. During this period, he deliberately managed to play the system, running a billing company named SJ Healthcare Management Services, LLC. This company, formed exclusively by Newcombe, was entrusted with handling the fiscal nuts and bolts for two doctors' practices in his hometown. The catch here was his sly move to gradually and consistently submit false claims. These claims varied from exaggerating the extent of services provided to billing for phantom procedures. His scam not only affected public insurance but private insurers were also taken for a ride.
In a more detailed light, the fraudulent activities undertaken by Newcombe were far from subtle. Upon examining the technicalities, he had not only fabricated claims for nonexistent services but also inflated reimbursement rates for procedures that did occur, albeit at a lower cost. In one instance, as admitted in his guilty plea, he laid out claims for medical services allegedly rendered to him by a provider, except those services were purely fictional, as detailed by the U.S. Attorney's Office.
This case, which was brought to a close through the investigative efforts of the FBI and HHS-OIG, ended up in the hands of Assistant U.S. Attorneys Michael D. Gadarian and Adam J. Katz. To hold Newcombe accountable, investigators had to uncover his deceptive billing schemes, which were carefully designed to evade ethical scrutiny. Ultimately, they were able to gather solid evidence of his fraudulent activities.
