The End of a Fraudulent Career

267

Not all crimes lead to time behind bars. But, the alternative punishment for defrauding a government healthcare benefits program can be as equally devastating to the perpetrator’s life as jail. Today’s fraudster is a Stamford, Connecticut dentist who agreed to a settlement that resolves allegations of his participation in a Medicaid fraud scheme involving the submission of false claims for dental services provided to long-term care facility residents. (While his punishment did not include time behind bars, it effectively ends his career.)

The Connecticut dentist and his wife owned four dental companies. One of them was a mobile clinic that provided dental services to senior citizens residing in nursing homes around the state. (He had a habit of billing Medicaid for services he didn’t provide and for dentures that were improperly made and packaged. He pocketed the cash for his own use.)

During one two-month period, he allegedly billed Medicaid and the Connecticut Department of Social Services $25,661 for dental services that were never rendered. Just on one day alone, he purportedly billed the government healthcare benefits program nearly $18,000 for providing 261 dental procedures on 71 patients in four different locations. (That’s pretty darn good considering the man is a septuagenarian. I’m not sure someone even half his age could keep up with that pace.)

After the state’s Department of Social Services (DSS) office paid the dentist’s unusually large bills related to his participation in the Connecticut Medical Assistance Program (CMAP), the organization suspended payment explaining that here were credible fraud allegations against him. Then the state’s Division of Criminal Justice got involved and sent investigators out to the four nursing homes where he claimed he saw 71 patients in one day. (As you might guess, the investigators found no indication that he had been there or saw any of the patients even though he billed Medicaid for $5,682 that particular day.) In reality, he didn’t visit the facilities on the dates he claimed and was even hospitalized during a period of that time.

The dentist and his wife agreed to forfeit $755,956.30 in payments suspended by the DSS to resolve the Medicaid fraud allegations. (Smart move since the evidence seemed to be overwhelming.) In addition, he agreed not to renew his now-expired dental license. Plus, he will not be able to participate in the CMAP program for 10 years.

Fraudsters don’t always have to be put behind bars to suffer the consequences of committing a crime. This elderly dentist has received an effective punishment for preying upon vulnerable citizens who deserved much better treatment than they received. (His career is definitely over. Case closed.)

Today’s “Fraud of the Day” is based on an article entitled, State reaches settlement with Stamford-based dentistposted on HartfordBusiness.com.

A Stamford-based dentist will be excluded from participation in the state’s Medicaid program for 10 years and will agree not to renew his expired dental license as part of a settlement resolving allegations he engaged in a scheme to submit false claims for dental services provided to residents of long-term care facilities in the state.

The announcement was made Tuesday by Attorney General George Jepsen and state Department of Social Services (DSS) Commissioner Roderick L. Bremby.

SHARE
Previous articleWigging Out
Next articleNot If, But When
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.