The dental industry sometimes witnesses its professionals committing insurance fraud — often through overtreatment, unnecessary sedation, upcoding tooth sealants to fillings or abusing so-called encounter fees.
Below are eight insurance fraud cases dentists faced in 2020, as covered by Becker's Dental Review.
- Connecticut dentist Abbas Mohammadi, DDS, agreed to pay a $300,000 settlement after allegedly overbilling for services and allowing uncertified dental assistants to perform procedures they were not qualified to do.
- San Diego dentist April Ambrosio, DDS, had her dental license suspended and was sentenced to six years in prison after she pleaded guilty to fraudulently billing insurance companies $866,700.
- Denver Tackett, DMD, owner and operator of McDowell, Ky.-based Tackett Family Dentistry, pleaded guilty to healthcare fraud, saying he submitted false claims and claims for unnecessary treatment to Kentucky Medicaid for reimbursement.
- Anthony DiStefano III, DDS, and Scott Cale, DDS, were indicted for allegedly defrauding MassHealth, the Massachusetts Medicaid program.
- Seth Lookhart, DMD, an Alaska dentist who extracted a patient's tooth while on a hoverboard, received a 12-year prison sentence for dozens of charges, some of which were for Medicaid fraud.
- Missouri dentist Bradley Seyer, DDS, was sentenced to 18 months in prison and ordered to pay a $50,000 fine after pleading guilty to Medicare fraud and illegally prescribing narcotics.
- Yun Sup Kim, DDS, of Emerald Terrace Dental in Swansea, Ill., pleaded guilty to a Medicaid fraud scheme that spanned three years.
- David Palo, DDS, a former oral surgeon at Lehrian & Palo Oral Surgery in Erie, Pa., agreed to enter a pretrial diversion program and pay nearly $47,000 to avoid ongoing prosecution in federal court for an insurance fraud case.
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