Modern Day Pirate

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Pirates are generally known for making threats, kidnapping hostages, stealing treasure and committing murder on the high seas. While today’s fraudster didn’t threaten, kidnap or murder anyone, he did steal a small fortune from the government by committing $1.7 million in Medicaid fraud over a three-year period.

According to the latest assessment from the Government Accountability Office (GAO), Medicaid fraud cost the federal government in excess of $36 billion in Fiscal Year 2016 (Or, to put that number in perspective, 10.5% of total Medicaid expenditures for the year). This was an increase over the approximately $29 billion in fiscal year 2015. (While $1.7 million doesn’t sound like much when compared to these numbers, just remember that no matter the size of the take, it all adds up.)

The Detroit, Michigan dentist in today’s article fled to the Caribbean after improperly billing the government healthcare program for dental services. It’s important to note that the dentist, who had previously been convicted of Medicaid fraud more than a decade ago, apparently did not learn from his first mistake. (Just like a pirate, he was moving on to other seas to abscond with his treasure. But, little did he know, the bounty hunters were hot on his trail.)

The Michigan dentist was exposed after someone reported that he had used the identifying information of another Medicaid-eligible dentist to submit fraudulent claims. (He was banned from billing Medicaid due to his previous conviction, so he used another dentist’s credentials to keep his scam running.) Instead of facing the consequences of his poorly considered actions, the veteran fraudster decided to flee to the Dominican Republic in a flimsy attempt to avoid justice.

The 51-year-old modern-day pirate didn’t sail the high seas for long before he was apprehended by the U.S. Marshals Service. He is now charged with 27 separate felony charges, including one count of racketeering (a 20-year felony), 20 counts of Medicaid fraud (a 10-year felony), and six counts of Healthcare Fraud (a four-year felony). Keep in mind that this dentist is innocent until proven guilty. (However, you have to admit, it’s hard to look past his previous conviction.) A formal press release from the Michigan Attorney General’s office, notes that the dentist has since been transferred back to Michigan after waiving extradition.

The dentist, who operated his fraud scheme through his own dental practice in Detroit, sold the company. (This was probably a good move considering the hefty legal fees he will probably face in the near future). Let’s just say that this repeat offender’s future interactions with the justice system will probably be more painful than a wisdom tooth extraction and a root canal combined.

Today’s “Fraud of the Day” is based on an article entitled, “Fugitive Macomb dentist wanted in Medicaid fraud case nabbed in Caribbean,” published by the Detroit Free Press on October 3, 2017.

A Macomb County dentist faces Medicaid fraud felony charges after being apprehended by U.S. Marshals in the Dominican Republic last week.

Dr. David Johnson, who fled the country last spring after Attorney General Bill Schuette filed 27 separate felony charges against him, will be arraigned in the coming weeks at the 54B District Court in Ingham County.

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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.