MEDIA, PA — A Delaware County doctor is facing fraud charges after allegedly making false insurance claims tied to opioid addiction drugs, county officials said.

Delaware County District Attorney Katayoun M. Copeland said Doctor Richard M. DiMonte, Jr., 54, of Media, is charged with fraudulent insurance claims and theft by deception in the amount of $394,900, involving Vivitrol, a medication prescribed to treat opioid addiction. DiMonte is a physician who practices family medicine and owns Front Street Family Medicine and Jasper Health Incorporated based in Media. He is a provider of Vivitrol and Suboxone, which are medicated assisted treatments for opioid addicted patients.

DiMonte is charged with 152 counts of felony false and fraudulent insurance claims and four counts of felony theft by deception The Delaware County District Attorney's Office Criminal Investigation Division (CID), Independence Blue Cross Investigators and AmeriHealth Caritas Insurance Investigators led the investigation into DiMonte's alleged crimes.

Investigation revealed that Independence Blue Cross and AmeriHealth Caritas insurance companies were paying multiple pharmacies to provide Vivitrol to DiMonte. Many patients had numerous Vivitrol shots sent to DiMonte in their name and paid for by their insurance companies, that they never received from Doctor DiMonte. This caused false insurance claims and inaccurate payments by the insurance companies for undelivered services to DiMonte's patients along with a stockpile of Vivitrol, which Doctor DiMonte then administered to other patients, charging uninsured patients cash.

On July 28, 2015, CID Sergeant Lawrence Patterson met with Independence Blue Cross investigators regarding possible insurance fraud being committed by DiMonte. This investigation revealed order and billing discrepancies where more Vivitrol vials were being requested and shipped to DiMonte than were being administered to prescribed patients. This resulted in a $200,200 loss to Independence Blue Cross in fraudulent insurance claims where patients did not receive their Vivitrol prescription, which was billed to their insurance company and delivered to DiMonte.

Further investigation revealed that DiMonte also billed AmeriHealth Caritas Insurance for Vivitrol. CID Detective Edward Kazlo and Sergeant Patterson met with AmeriHealth Caritas investigators on January 11, 2017, that revealed a similar discrepancy where DiMonte received more Vivitrol than what he administered to patients. This resulted in a $194,700 loss to AmeriHealth.

CID detectives interviewed more than 100 of DiMonte's patients who had either Independence Blue Cross or AmeriHealth Caritas medical insurance. The interviewed patients described the number of Vivitrol shots they received, which were consistently less than the shots billed to the insurance company and the quantity mailed to DiMonte. Analysis of DiMonte's patient records and investigation revealed that 152 patients were prescribed Vivitrol that was sent to DiMonte and billed to their insurance company even though these patients never received the medication.