Thursday, July 19, 2012

Las Vegas Dentist Pleads Guilty to Health Care Fraud


Posted: Jul 19, 2012 6:42 PM CDT
Updated: Jul 19, 2012 10:55 PM CDT
By Steve Kanigher, I-Team Reporter - email

Las Vegas Dentist Pleads Guilty to Health Care Fraud

LAS VEGAS – A dentist and his office manager pleaded guilty this morning to felony health care fraud for submitting false claims to a labor union's insurance administrator for dental work that was not performed, Nevada's U.S. Attorney Daniel Bogden said.

Mauricio Vargas, 50, and Enoc Adrian Renteria, 33, both of Las Vegas, pleaded guilty to one count of conspiracy to commit health care fraud. They face up to five years in prison and a $250,000 fine, and are scheduled to be sentenced Oct. 17 by U.S. District Judge Gloria Navarro.

According to the plea agreements, Vargas as a licensed dentist who operated AV Dental in Las Vegas, and Renteria as his office and marketing manager, conspired with an employee of Laborers Union Local 872 to submit false billing claims to the union. Local 872 is self-insured and contracted with a third-party administrator to adjudicate and pay claims on behalf of union members.

AV Dental was previously barred from submitting claims on behalf of union members. With Vargas' knowledge, though, Renteria cultivated a relationship with the union employee and submitted claims to the third-party administrator for dental work that was not actually performed. The claims were falsely backdated to a point before AV Dental was barred from submitting claims. Renteria paid bribes to the union employee for approving or getting the false claims approved. Vargas deposited $209,406 of union checks into a bank account he owned. The checks represented payment from the union for dental services not actually rendered to union members.

The investigation is being conducted by the FBI, and the case is being prosecuted by Assistant U.S. Attorney Crane Pomerantz.