Conviction on charges of Medicaid fraud have resulted in five years of probation, including two years of home incarceration, for a Shreveport dentist. The dentist was found guilty in January on two counts of Medicaid fraud. In addition to probation and home incarceration, the dentist will have fines, restitution and community service to perform.
The man reportedly pleaded no contest to charges of Medicaid fraud in 1992, and was afterward excluded from the Medicaid program. He is still excluded to this day, but was able to participate by obtaining employment with a Shreveport dentist between 2005 and 2007. The dentist that employed him is now reportedly deceased.
Prosecutors alleged that the dentist treated Medicaid recipients, submitted false billing claims to Medicaid under the other dentist’s provider number and received payment from Medicaid. Individuals excluded from Medicaid are, according to prosecutors, in the case, not permitted to be employed by, contract with or have ownership interest in a health care provider that bills to Medicaid.
Health care fraud is a large business, and there is no doubt that there are providers out there that take advantage of the system. But not every provider who is charged with Medicaid fraud is guilty, and among those who are, the charges don’t always fit the crime.
Having an experienced advocate is important in fraud cases, as defendants are typically confronted with evidence that can be difficult to sort through and law which isn’t easy to understand and apply. The earlier on in the process one begins building a defense, the better.
Source: SF Gate, “Dentist sentenced for Medicaid fraud,” July 5, 2012