By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On October 1, 2021, a former dental office manager was sentenced to 12 months in prison for her role in a Medicaid fraud scheme. The office manager for Universal Smiles, a D.C.-based dental practice was sentenced for her guilt in bilking Medicaid, according to the U.S. attorney’s office for D.C.
The office manager was indicted in January 2019, along with the dentist who ran the practice. The office manager pleaded guilty in May 2021 in the U.S. District Court for the District of Columbia and admitted she received over $813,000 through false billings.
The Fraudulent Billing Scheme.
Through the dental practice, she and the dentist allegedly both participated to defraud the D.C. Medicaid Program. As part of the scheme, both the dentist and the office manager allegedly billed Medicaid for thousands of provisional crowns, a significant number of which were not provided to the patients. From August 9, 2012, through February 26, 2014, D.C. Medicaid paid Universal Smiles approximately $5.4 million. Of that amount, the office manager allegedly received approximately $813,184.
The amount paid by Medicaid to the dental practice, $5.4 million for an 18 month period, should have raised red flags for anyone seeing it. Apparently, it did. And for an office manager of a dental practice to receive $813,000 for an 18 month period, ditto.
As part of the sentence, the office manager has been ordered to pay back the full amount she received from Medicaid. She will also serve three years of supervised release following the completion of her one-year prison term.
Click here to read the press release by the Department of Justice (DOJ) and learn more.
To read about a similar case that also deals with a healthcare professional, click here to read my prior blog.
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Martin, Colleen. “Rockville Woman Defrauded Medicaid At Dental Office: US Attorney.” Patch. (October 4, 2021). Web.
Bethesda Beat Staff Reporter. “Rockville woman to serve prison term over D.C. Medicaid fraud.” Bethesda Magazine. (October 4, 2021). Web.
About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620. Toll-Free: (888) 331-6620.
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