Law & Justice

Roxbury Chiropractor Sentenced for Role in Insurance Fraud Ring

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TRENTON – A chiropractor who lives in Roxbury was recently sentenced to two years probation and 40 hours of community service for his involvement in a multi-level insurance fraud ring that preyed on car crash victims, according to authorities.

The man, Edward Formisano, 55, of Roxbury, pleaded guilty to one count of third-degree health care claims fraud in connection to his role in the scheme, said state Attorney General Christopher Porrino. He said Formisano was the “purported owner” of Eclipse Chiropractic in Plainfield, Lakewood Chiropractic in Lakewood, Liberty Chiropractic Center in Jersey City and Chiropractic Spine Center in Perth Amboy.

Porrino and the Office of the Insurance Fraud Prosecutor (OIFP) said two brothers from Colts Neck were sentenced to six-and-a-half-year prison terms “for masterminding a multi-level insurance fraud ring in which they paid illegal ‘runners’ to recruit car crash victims as patients for chiropractic facilities they controlled, and also collected kickbacks for referring those victims for medical and legal services provided by others involved in the scheme.”

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The brothers, Anhuar Bandy, 54, and Karim Bandy, 55, were ordered to pay $100,000 fines each and $50,000 reimbursement to insurance companies, said Porrino. He said the insurance companies paid thousands of fraudulent claims over a four-year period. Formisano was one of 13 other members of the fraud ring, said the attorney general. He said the ring included a doctor, a lawyer, three licensed chiropractors, a paralegal and a licensed acupuncturist.

“Anhuar and Karim Bandy were the ringleaders of a morally bankrupt band of criminals,” Porrino said. “They lured unsuspecting accident victims into their scheme and then steered them toward corrupt medical and legal professionals in exchange for cash,” he said. “After years of illegally making money off the misfortune of others, the Bandy brothers are now paying the price for their criminal greed.”

Christopher Lu, the state’s acting insurance fraud prosecutor, said investigators “worked diligently to unravel the defendants’ web of lies and deceit and put a stop to a criminal enterprise that compromised the care of vulnerable accident victims and undermined the integrity of New Jersey’s legal, medical, and insurance industries.”
The indictment charged that between June 1, 2009 and Jan. 1, 2014 the Bandys illegally controlled several chiropractic facilities through purported “management companies” and “marketing companies.”

The grand jury found that the companies’ real purpose was to hide their ownership; state regulations require that chiropractic facilities be owned by licensed chiropractors or medical doctors and neither Bandy holds such titles, said the authorities. To make money for the chiropractic facilities, the Bandy brothers “used runners to bring motor vehicle accident patients to the facilities so the straw owners could bill insurance carriers for services rendered at the facilities,” according to Porrino.

The probe found that the chiropractic facilities “billed insurance companies for millions of dollars for services they purported to perform.” The money was deposited into accounts of the chiropractic facilities or the management companies and much of the money would later be paid to the Bandy management companies.
“The runners were paid up to $1,000 for each patient that they recruited for medical treatment,” Porrino said. “An investigation determined that the runners retrieved motor vehicle accident reports at local police stations, under the Open Public Records Act rules, and then visited the homes of the motor vehicle accident victims in an attempt to persuade them to utilize the services of the chiropractic facilities controlled by the Bandy brothers.”

Then, the runners drove the accident victims to the chiropractic facilities,” Porrino said. He said payments were made to Karim Bandy’s companies for more than 1,000 referrals of patients.

Among the others involved in the scheme was Rockaway lawyer David Walker, 58, who pleaded guilty to one count of third-degree conspiracy and was sentenced to two years of probation and 40 hours of community service, Porrino said.

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