Plattsburgh Medical Billing Company Owner Sentenced for Health Care Fraud

A Plattsburgh man was sentenced to probation and ordered to pay restitution after pleading guilty to health care fraud, federal officials announced Thursday.

Scott Newcombe, 41, was sentenced to one year of probation and must repay $34,583.21 for submitting false and fraudulent claims to insurers. The sentencing took place in the U.S. District Court for the Northern District of New York.

According to the U.S. Attorney’s Office, Newcombe owned and operated SJ Healthcare Management Services, LLC (SJHMS), which provided administrative and billing services for two physicians' practices in Plattsburgh. From April 2020 through April 2023, he submitted fraudulent claims to both public and private insurers, seeking reimbursement for services that were either not performed or billed at higher rates than justified.

Prosecutors stated that in some cases, Newcombe billed for medical procedures that were never provided, including claims for services allegedly performed on himself that did not occur.

The Federal Bureau of Investigation (FBI) and the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) investigated the case. Assistant U.S. Attorneys Michael D. Gadarian and Adam J. Katz prosecuted the matter.