The Medicaid fraud investigation began when an employee in the dentist’s office contacted the Medicaid Fraud Control Unit at the Attorney General’s office.
According to the government, the investigation revealed that the dentist was engaged in dental fraud by submitting several different types of false claims to Medicaid, including:
- billing for dental fillings that were not provided;
- billing for poor quality x-rays that had no diagnostic value;
- providing fraudulent dates of service so he could bill for more than one set of dentures every five years;
- billing for sedative fillings that were not provided or not medically necessary.
The dentist agreed to settle the charges of dental fraud by pleading guilty to one felony count of billing Medicaid for services not provided. In his plea, the dentist admitted that he billed Medicaid claims for surgical extractions or post-surgical complications when the procedure was only a simple tooth removal with no complications.
Medicaid fraud penalties can be harsh. While this dentist was sentenced only to probation, a small fine, and restitution, his ability to practice as a dentist is now at risk. Because he pleaded guilty to a felony, he faces exclusion from Medicare and Medicaid programs, as well as professional disciplinary charges that could include suspension or revocation of his professional license.
New York Medicaid fraud investigations often begin with a request for records or other documents from an investigator. If you practice in New York City, that request often comes from an investigator located at 250 Church Street in Manhattan.
A request for records means that the government has already commenced its investigation, gathered evidence against you, and suspects that you have done something wrong. Anything you say or do at this point will be used against you.
If you are under investigation or have been charged with Medicaid fraud, then you should consult with an experienced Medicaid fraud attorney immediately. How you handle the investigation can mean the difference between retaining or losing your rights, your livelihood, and your professional license.
To arrange a consultation with an experienced Medicaid fraud attorney, call John Howley, Esq. at (212) 601-2728 or click here to reach us via email.
John Howley, Esq.
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