Pennsylvania’s Dental Meeting 2018
The trial began in February 2008, an
experience that could only be described
as nine days of torment. The result of
the trial…guilty and I surrendered
my license to practice dentistry for
revocation in July 2008. The investigation
and prosecution was based on the
reimbursement I had received for
services provided to Medicaid patients
over the course of 6.5 years, from 1996
- 2003. Living in the poorest county of
Virginia where more than 90 percent
of the residents under the age of 18
qualified for Medicaid services, I had
a very busy Medicaid practice. Those
patients were children of my family,
friends, neighbors, and certainly
deserving of dental care. During this
6.5 year period, I had been reimbursed
around 3.5 million dollars. Busy
Medicaid practice? Yes.
The jury was not made aware of nor
involved with establishing the amount
of the overpayments that I received.
Of the 3.5 million dollars
paid to me over the
course of 6.5 years, the
amount the government
established I was
overpaid was $17,899.57,
a half of a percent of the
entire amount paid
during the period.
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JU LY/AU GU ST 2017 | P EN N S YLVA N IA D EN TA L J O UR N A L
Should those overpayments been
identified and returned? Yes. Did I
receive reimbursements in error? Yes.
Even though we were able to establish
that there were services that I could
have billed and been reimbursed for
but didn’t in an amount in excess of this
overpayment, it made no difference. Truly, seeing my family suffer as a result
of my actions (or inaction) was the most
difficult part of the entire ordeal. Even
so, things have changed in a positive
way despite the odds stacked against
me. My license to practice dentistry
was restored in December 2011; quite
the miracle.
We believe the action was initiated by
a direct complaint by a whistleblower
to the Medicaid Fraud division of the
FBI in the western district of Virginia.
We don’t know because that information
is protected by the whistleblower statute.
It was clear that the action was not
initiated by the Department of Health
and Human Services (Medicaid). The
administrator of the Virginia Medicaid
program conducted two audits during
the course of the investigation and
both of them came back “clean” so that
I was able to continue to see Medicaid
patients until the day I surrendered
my license in July 2008. During the investigation, after my arrest
and while preparing for the trial, I received
a PHD from the world of hard knocks
about what I did, what I should have
done and what I could have done to
better defend myself in the event of
a challenge.
I was sentenced in July to 24 months
in prison, fines and penalties of $75,000,
and I forfeited everything the government
confiscated when I was arrested.
I was released from prison in February
2010 and my probation ended in May
2013. It was a long difficult ordeal,
especially for my family.
Since my release, my life has been
focused on and devoted to educating
myself and educating my colleagues
of the dangers that now exist to the
doctor and practice if certain standards
are not met and proper protocols
established and followed. I work to
provide proper tools and techniques to
maximize legitimate reimburse and to
reduce the risk associated with the
practice of dentistry. I have a passion
to share my story and my experiences
in a hope that I can help prevent what
happened to me from happening to
anybody else.