Heartless

255
39585925 - female doctor's face wearing protective mask and green surgeon's cap closeup. surgeon's eyes close up gazing intently in camera. resuscitation concept.

Dental phobia is real. Even though most dental procedures don’t cause pain, some of the sharp objects used by dentists can cause quite a bit of anxiety. (At least there is comfort in knowing that the person coming at you with a tiny drill has a license and knows what they are doing.) It was probably a good thing that the patients visiting an Idaho dental practice did not know that the person taking care of their dental needs was not a dentist, nor did she have a dental license. Today’s fraudster masterminded a Medicaid fraud scheme that cost the government healthcare system hundreds of thousands of dollars.

The fake dentist in today’s case was actually a licensed dental hygienist. She opened a dental practice and called it, “Dental Healthcare With Heart.” She employed part-time licensed dentists and paid them a portion of the money she collected from healthcare benefit providers for the services they performed. (She also received compensation from the insurance providers for performing dental procedures under the guise of one of her employees.)

She carried out her illegal ruse by taking advantage of an employee who was actually receiving in-home healthcare. (He was declared fully disabled due to some severe health problems.) Even though he did not practice dentistry because of his ailments, she continued to bill Medicaid and other insurance providers for services that he purportedly performed over three years. During that time, the dental practice owner billed Medicaid and other insurance providers $1.5 million.

Some of the procedures she performed included drilling and pulling teeth, providing fillings and dentures, plus other procedures that were not allowable under her dental hygienist license. The dental practice owner also certified medical records, letters and bills with the disabled dentist’s signature stamp to authenticate her fraudulent bills. The dental practice owner deposited the Medicaid payments into retirement accounts for her and her husband.

Evidence presented in court showed that the dental hygienist also renewed the disabled doctor’s dental license and his license for prescribing controlled substances. She even completed some required online continuing education courses for him. (When other contract dentists asked where the disabled dentist was, the dental hygienist would say that he worked on a different day.)

The 62-year-old dental hygienist pleaded guilty to 24 counts of healthcare fraud and another 24 counts of aggravated identity theft. She was sentenced to five years in prison for completing dental procedures that should only be performed by a licensed dentist. The judge also ordered her to forfeit $847,016 in illegal proceeds and pay $549,605 in restitution. The Idaho State Board of Dentistry pressured her into surrendering her dental hygienist license right after the allegations were made. (I’d say that is a fair sentence. Let’s hope that she didn’t harm any patients by misrepresenting herself.)

So, in addition to having dental phobia, this woman’s patients may now also have dental fraud phobia as well. If anything, this case should serve as a warning for all Medicaid patients (or any person receiving any kind of medical care) to check out their dental and medical providers’ credentials before having any services provided. This dishonest woman, who claimed to operate her dental practice with “heart’ was actually a heartless criminal who only cared about herself.

Today’s “Fraud of the Day” is based on an article entitled, She pulled teeth, provided fillings, but wasn’t a dentist and is headed to prison,” published by the Idaho Statesman on June 7, 2017.

Cherie R. Dillon, 62, will spend five years in prison for completing dental procedures that legally could only be performed by a dentist.

Dillon drilled and pulled teeth, provided patients at her Payette office with fillings and dentures, and offered other procedures that went far beyond her license as a dental hygienist. Dillon did not attend dental school and did not have a license beyond a hygienist’s.

SHARE
Previous articleDriven to Defraud
Next articleHonesty Makes a Huge Difference
Larry Benson
Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.