Upstate medical billing company owner pleads guilty to healthcare fraud

by Olivia Jaquith

ALBANY, N.Y. (WRGB) — A Plattsburgh man pled guilty Tuesday to healthcare fraud, federal prosecutors said.

According to a release, Scott Newcombe, 40, as part of his plea, admitted that from approximately April 2020 through April 2023, he acted as the office manager and healthcare claims biller for two physicians’ practices in Plattsburgh through a company that he formed, called SJ Healthcare Management Services, LLC. The company reportedly charged a fixed monthly fee, under which prosecutors said Newcombe performed various management, administrative and billing services for the practices.

Prosecutors with the U.S. Attorney’s Office for the Northern District of New York (NDNY) said Newcombe further admitted that he submitted false and fraudulent claims to public and private insurers on behalf of the aforementioned practices for services that, in some instances, were never provided and, in other instances, were provided at lower reimbursement rates than the amounts billed.

Newcombe is scheduled for sentencing on Feb. 28, 2025, according to a release. He faces up to 20 years in prison and a term of post-imprisonment supervised release of up to three years.

The Federal Bureau of Investigation (FBI) and U.S. Department of Health and Human Services (HHS) investigated this case.

Full Article & Source:
Upstate medical billing company owner pleads guilty to healthcare fraud