Thursday, October 10, 2013

Dentist, Gary Anusavice sentenced to 8 years in prison for Medicaid Fraud


CBS Conn

Prison time for a Connecticut dentist who swindled millions from the federal Medicaid program.

Gary Anusavice, 60, used recruiters, to seek poor patients who used Medicaid. Then he would perform unnecessary dental procedures and file fraudulent Medicaid claims that added up to $20 million, $3.3 million he collected for himself from 2008 through 2012.

Anusavice is now sentenced to eight years in prison and has been ordered to pay $10 million in fines, give up his luxurious Rhode Island home, a boat, his Mercedes, and about $90,000 in cash found at his home.

He operated a network of clinics where the fraud went on in the central, southern and western parts of Connecticut.


Dentist In Massive Medicaid Fraud Case Sentenced To 8 Years

By EDMUND H. MAHONY, The Hartford Courant
9:32 p.m. EDT, October 9, 2013

HARTFORD — A dentist barred from practicing elsewhere in New England was sentenced Wednesday to eight years in prison for operating assembly line-style clinics in Connecticut that targeted poor patients, performed unnecessary dental procedures and collected on more than $20 million in fraudulent claims from Medicaid.

Gary Anusavice, 60, operated networks of clinics in the south, central and western parts of the state from 2008 to 2012 and personally collected more than $3.3 million from the fraud.

Under a variety of settlements with the state and federal governments, Anusavice will pay more than $10 million in fines and restitution, in addition to giving the government his 8,000-square-foot home in Rhode Island, his boat, his Mercedes-Benz and about $90,000 in cash that investigators found in the home.

Anusavice opened clinics in areas where high concentrations of low-income people relied on the federal government's Medicaid program for medical treatment. Medicaid, which is administered in Connecticut by the state Department of Social Services, reimburses physicians for costs they incur while treating patients who are unable to pay.

The Anusavice clinics hired recruiters to leaflet poor neighborhoods, paying commissions to those who delivered patients. The clinics also offered shuttle services to and from appointments for patients, according to federal prosecutors and information presented in U.S. District Court.

Anusavice conceded the charges against him in Connecticut — health care fraud and tax evasion — when he agreed to plead guilty in federal court earlier this year. He failed to declare income from his Connecticut clinics and admitted paying others to hide money by shuffling it among accounts and phony companies.

"I apologize to the court and to anyone who was hurt by me and my activities," Anusavice said in court.

As his three sons sobbed in the gallery, U.S District Judge Vanessa L. Bryant called Anusavice "a persistent, diabolical, criminal."

"It's not a victimless crime," Bryant said. "You stole from each and every American."

Bryant said the theft allegations didn't begin to account for the discomfort suffered by patients who had "teeth unnecessarily drilled" or underwent other questionable dental procedures.

Bryant accused Anusavice of "slinking" into Connecticut after losing his dental licenses and being barred from participation in Medicaid in Massachusetts and Rhode Island.

His first run-in with authorities was in Massachusetts in 1997, when he was convicted of making false health care claims in that state. Over the next eight years, he was convicted in federal court of filing false tax returns and punished administratively by licensing boards in Massachusetts and Rhode Island.

By 2006, materials filed in court show, he had lost his dental licenses in both states and had been barred from participating in the Medicaid reimbursement program. His most severe punishment for a criminal offense was four months of home confinement on the tax charge.

Two years later, Connecticut announced that it was increasing the amount Medicaid pays to in-state dentists in an effort to increase the number of dentists participating in the program. The goal was to induce more dentists to treat low-income patients.

Within months, Anusavice had relocated to Connecticut and was setting up the first of his clinics, federal prosecutors said.

Anusavice hid his involvement, using phony names and trying to avoid signing documents, according to materials filed in court. But he was closely involved in the operation of the offices. Among other things, he hired dentists and support staff and trained them in submitting Medicaid claims.

Authorities described his clinics as "high production" offices. Prosecutors said he paid dentists based on the numbers of procedures they performed and "frequently criticized dentists for falling short on their production."

Assistant U.S. Attorney Susan Wines said Medicaid reimbursements to Anusavice clinics, made every two weeks, typically spiked as the clinics opened and began operating. In the case of the first group of clinics, she said, the payments began in the range of "tens of thousands of dollars" and soon rose to as much as $500,000.

Fraud investigators at the state Department of Social Services first detected illegal involvement by Anusavice in fraudulent practices, and the subsequent investigation came to involve state and federal prosecutors, as well as investigators with U.S. Department of Health and Human Services, which administers the federal Medicaid program.

The investigation eventually included a cooperating dentist who agreed to work undercover for the government. The undercover dentist recorded Anusavice during an employment interview, according to prosecution filings in court.