Medical billing company owner pleads guilty to fraud scheme

The owner of a medical billing company pleaded guilty to submitting false claims to public and private insurers. 

Scott Newcombe, 40, of Plattsburgh, N.Y., acted as the office manager and healthcare claims biller for two physicians' practices in the city through a company he created called SJ Healthcare Management Services, according to an Oct. 29 Justice Department news release. He worked for those practices from April 2020 through April 2023.

His company charged a fixed monthly fee and Mr. Newcombe performed various management, administrative and billing services for the practices, according to the release. He admitted to submitting false claims to payers on behalf of those practices for services that in some cases were never performed and in other cases were provided at lower reimbursement rates than the amount billed. 

Mr. Newcombe is scheduled to be sentenced Feb. 28. He faces up to 20 years in prison. 



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