Showing posts with label Medicaid Dental Fraud. Show all posts
Showing posts with label Medicaid Dental Fraud. Show all posts

Saturday, April 09, 2016

June 13, 2016 is the date set for the fraud case against Dr. Howard Schneider of Jacksonville, Florida

April 4, 2016
- A trial date has been set for embattled pediatric dentist Dr. Howard S. Schneider, who is facing 11 counts of Medicaid fraud.

Schneider, 78, pleaded not guilty to those charges and one count of scheme to defraud.

More Jacksonville Headlines

His lawyers argued unsuccessfully last month to have the charges dismissed.

Schneider's trial is set to begin June 13.

Schneider remains free on $110,000 bond and is now living in St. Simons Island, Georgia.

Read the entire story here.

Monday, November 16, 2015

Dr. Howard S. Schneider Arrested for 11 Counts Medicaid Fraud

Nov. 16, 2015

Dr. Howard S. Schneider of Jacksonville, Florida has been arrested this afternoon.

Pediatric dentist accused by a group of parents of hurting children, was arrested Monday.
According to the Jacksonville Sheriff's Office Inmate Information Search, Schneider was arrested on 11 counts of unauthorized Medicaid claims.
Schneider turned himself into to JSO around 4 p.m. Monday, according to the office of Attorney General Pam Bondi.

His total bond is listed at $110,033, according to JSO's Inmate Information Search. Schneider does not have a court date scheduled at this time.

- See more at:

On November 13, 2015, Schneider filed for an emergency distribution of marital funds in anticipation of his arrest.





















Howard Schneider Charges.pdf by Dentist The Menace

Monday, January 26, 2015

Scams on the public by nonprofit dental clinics



By: Michael W. Davis, DDS

Dr. Michael W. Davis practices in Santa Fe, NM. He currently chairs the district dental society peer-review committee, and is active as an expert witness on dental legal cases. He has authored numbers of articles relating to clinical dentistry, dental ethics, and protections for the public.

The recent legal settlement between Sea Mar Community Health Centers, which provides dental services to low-income residents in 10 Washington state counties, and the Washington state attorney general’s office, for $3.65 million highlighted this growing problem. These scams don’t generally benefit the professional staff, patients, contributors, and certainly not taxpayers. These swindles are designed to elevate overall clinic revenues, to enhance salaries and benefit packages of clinic directors. These nonprofit clinic directors often have compensation packages comparable with those working for Fortune 500 companies. Most other employees are not tapping in on the dishonest largesse. Here’s how this particular hustle is played.

These clinics have favorable tax status not enjoyed by private sector companies. They are exempt from most taxes. Clinic “profits” are not taxable. However, these profits are rolled-over in the dishonest clinics, into increased personal revenue for the clinic directors. Dishonest clinic directors may also generate a kickback fee from vendors providing dental equipment and/or supplies, especially if unaudited.

Unlike private sector dental clinics serving the disadvantaged Medicaid population, nonprofit clinics may access federal, state, county, & charitable grant moneys. This can be a huge income generator, especially important since Medicaid fees are often set at a level below the cost to provide that service, to standard of care. Grant moneys provide the nonprofit clinic with a per patient served, “encounter fee”. Patient encounter fees are paid to Federally Qualified Health Centers (FQHC) as a set amount, per patient visit. The patient must lawfully visit with a duly licensed healthcare professional of that nonprofit healthcare clinic, for the FQHC encounter fee to be paid. This nonprofit encounter fee often ranges in the $200 per patient visit range.

Wednesday, November 05, 2014

Nearly 100 Indiana dentists found to have questionable billing in HHS Report



Feds: 95 Indiana dental providers have questionable billing

Marisa Kwiatkowski, 7:01 a.m. EST November 5, 2014

A federal report released Wednesday found questionable billing practices by 94 dentists and one oral surgeon who treat Indiana children on Medicaid.

Those providers received about $30.5 million in government funds for pediatric dental services, according to the report by the U.S. Department of Health and Human Services’ Office of Inspector General.

Federal officials did not cite specific dentists or clinics in the report, but said the findings demonstrate the need for improved oversight of pediatric dental services paid by Medicaid in Indiana.

Officials studied claims paid by Medicaid in 2012 for such dental services and focused on those who served more than 50 children.

Two-thirds of the dentists cited in the report for questionable billing worked for four dental chains. Three of those chains have been the target of state and federal investigations, according to the report.

Read the entire story here



HHS Report - Indiana Questionable Pediatric Dental Mediciad Billing November 2014


Saturday, May 24, 2014

Florida Dentists, Dr. Miranda W. Smith-Smiles and Giggles Dentistry-Arrested Medicaid Fraud

One of Dr. Miranda Smith’s patient had perfect teeth, yet in Smith’s treatment plan she pulled every tooth and fit the patient with ill-fitting 140523 miranda smith-florida-medicaid frauddentures; a pattern said investigators.

Other’s were children, sedated, for dental treatment they didn’t need.

Her husband blames the whole mess on “two disgruntled and racist employees”. And says, “She’s been fighting this for three years, nine employees and their families are out of work because of this”.


Christopher Torres, her attorney, says many of the charges have been disproved on an “administrative level” and believes the criminal charges won’t hold up.

Apparently the Feds think otherwise and have a 21-page affidavit to back it up with $140,000 in Medicaid fraud charges.

It’s not the disgruntled employees that concern me, it’s the ones who are happy at their job working for dentists like these.

Smiles and Giggles Dentistry for Children and Adults is located in Spring Hill, Florida.


Florida AG Press Release:

imageAttorney General Pam Bondi News Release

May 23, 2014
Media Contact: Jenn Meale
Phone: (850) 245-0150

Attorney General Pam Bondi’s Medicaid Fraud Control Unit and the Pasco County Sheriff’s Office Arrest a Tampa Bay Dentist

TALLAHASSEE, Fla. –Attorney General Pam Bondi’s Medicaid Fraud Control Unit, with the assistance of the Pasco County Sheriff’s Office, arrested Pasco County Dentist Dr. Miranda Smith on charges of Medicaid Provider fraud.

Dr. Smith, owner of Smiles and Giggles Dentistry for Children and Adults in Pasco County, allegedly billed Florida’s Medicaid program more than $140,000 in dental services which were either unauthorized or not provided.

The Attorney General’s Medicaid Fraud Control Unit initiated its investigation of Smith and her dental practice after receiving complaints about suspicious billing from parents and patients. According to the investigation, Smith billed Medicaid for x-rays, anesthesia, and other dental procedures that were not performed. Additionally, former patients alleged that Smith’s employees provided dental care, even though these employees were not licensed dentists.

According to the investigation, at least one minor patient's parent was told her child had eight cavities and would need to be sedated to perform urgent dental work. The parent received a second opinion from a dentist with more than two decades of experience. The dentist performed her own examination and found that the child had no cavities.

Investigators also found that Dr. Smith and staff exhibited a pattern of pulling healthy teeth in an effort to sell patients dentures and make larger Medicaid claims.

Smith is being charged with two counts of Medicaid Fraud. If convicted, she could face up to 10 years in prison and up to $10,000 in fines. The Attorney General’s Office of Statewide Prosecution will prosecute this case.

The Florida Department of Health’s Board of Dentistry voted on May 16, 2014, to suspend the license of Miranda W. Smith, D.D.S., in case number 2011-12390. This suspension will become a Final Order of the board within the next few business days.

I couldn’t help but compare the two pictures above! LOL

Never mind…

Thursday, March 27, 2014

HHS-OIG Report - Questionable Billing For Medicaid Pediatric Dental Services in New York–March 2014

This same study could be done in any state these private equity owned dental clinics operate and the results would be the same, if not worse. All of this has been reported right here since 2007, it’s 2014! Just saying…


Questionable Billing For Medicaid Pediatric Dental Services in New York - March 2014

DSO-PE graphic

Thursday, March 06, 2014

Analysis of ADC vs. Texas Health and Human Services Commission

Analysis of ADC vs. Texas Health and Human Services Commission

DrBicuspidBy Michael W. Davis, DDS, contributing writer

March 6, 2014 -- Why should anyone care about a dental Medicaid ruling from an administrative law court in Travis County in Texas? One reason is that this case involves several millions of taxpayer dollars. Other similar cases brought before this court of alleged dental Medicaid fraud and abuses have and will involve taxpayer money, in excess of $100 million.image 

The vast majority of dental Medicaid fraud cases are generally resolved in settlement agreements. Alleged violators usually pay some amount of restitution to the government in exchange for no admission of wrongdoing. Often, the alleged violators return to "business as usual." We, the public and dental profession, receive little or no data on case specifics. Records of investigations are sealed upon settlement.

Public record disclosure of this particular case exposed some of the dark underbelly of the dental Medicaid industry, along with some of its nefarious inner workings.

Read the entire article on Dr. Bicuspid

Thursday, February 27, 2014

Dr. Donald P. Prohovich pays $400,000 to settle fraud allegations in Massachusetts

The Enterprise




By Maria Papadopoulos
The Enterprise
Posted Feb. 25, 2014 @ 12:39 pm
Updated Feb 25, 2014 at 6:17 PM

An Easton dentist has agreed to pay $400,000 to the state’s Medicaid program to resolve allegations of improperly billing for visits to MassHealth members living in nursing homes, Attorney General Martha Coakley announced Tuesday.
An investigation found that Dr. Donald P. Prohovich, a dental provider in the MassHealth program, violated a regulation established in 2010 that limits payments for providers to one “house call” to a facility per day, Coakley said in a statement.

Investigators found that from July 2010 to September 2013, Prohovich allegedly improperly billed for house calls to elderly MassHealth patients in nursing homes in eastern Massachusetts on a per-patient, per-day basis.

Sunday, February 23, 2014

Flora Mounessa, DDS and husband—Shahram Sharif—arrested

Flora Mounessa, DDS and Shahram Sharif

Flora Mounessa,DDS husband, Shahram Sharif then and now.

According to Great Neck, NY District Attorney, the couple defrauded Medicaid out of $70,000, but this couple did it with a “twist”, not seen much here on DTM.

This couple underreported income and assets to obtain benefits. Dr. Flora must not be well schooled on the proper defrauding of Medicaid by dentists or this is the new “bonus” system.

According to reports, the couple actually had income of $2.74 million during the 5 year period. Just looking at the numbers it might look like they left out some zeros on their reports. I don’t know, and this is just a guess, but I bet there was some other Medicaid defrauding going on over at the dental clinic. Take a look at the “store front”, looks more like a pawn shop to me.

Office-Dr-Flora-Mounessa-DDS-Dentist-Hollis-Queens-3-150x150Greed may be good, as pointed out in the movie “Wall Street”, but it sure isn’t good for one’s looks,is it? “Road hard and put away wet” is what comes to my mind when checking out the mug shots.




minolapatchA husband and wife face felony fraud charges after underreporting assets and raking in more than $70,000 in Medicaid benefits, according to the Nassau County District Attorney's office.

Flora Mounessa, 39, and Shahram Sharif, 45, both of Great Neck, were each charged with one count of second-degree welfare fraud, one count of second-degree grand larceny, and one count of first-degree offering of a false instrument for filing.

The couple is accused of underreporting their assets enough to be able to claim Medicaid benefits for themselves and their daughter. They allegedly reported an annual income between $23,400 and $31,200. 

Between January 2005 and October 2010, the defendants received $70,193.64 in benefits. During that time, Mounessa worked as a dentist and Sharif was self-employed, buying and selling real estate. Their jobs raked in $2.74 million over the five years they were given benefits.

The couple was arrested and charged Friday after an investigation.

If convicted, the couple faces possible 15 years in prison, plus restitution and fines. The smallest consequence they could face is a conditional discharge, said the DA.

They were released by a judge and put on probation until they return to court March 11.

Dr. Flora Mounessa’s facebook pages says she works for Nora Family Dental, studied at NYU and prior studied at Yeshiva University (SCW)

Monday, December 16, 2013

The Medicaid gravy train continues

If you read this blog, then you know profits with Medicaid dentistry is made on high volume, gross excessive treatment, all at a single visit. The prime example is Small Smiles and their Production Per Patient (PPP) mantra handed out to their employed dentists. As testimony revealed in a New York malpractice case, "PPP is the Golden Goose", said one Small Smile executive. As was put another way by one of Small Smiles managers, “you eat what you kill”. 

It’s undeniable, years ago, Small Smiles Dental set the gold standard of excessive treatment by restraining children with use of the papoose board. 

As heat from press, parents and few state dental board followed some Medicaid accepting dentists and dental chains decided sedation would be the key even more profits, leaving the least amount of yuk in everyone's mouth—the children, the parents and especially the public.

Weekend "get-a-way" sedation courses were developed, lobbyist hired and representatives of the dental community were sent on press junkets stressing the need for higher reimbursements from insurers and Medicaid; all to accomplish the same thing—Production Per Patient. Now, as ABC news has reported in 2012, we have children being overdosed, brain damaged and dying at an alarming rate.

All the while, government regulators appear to be hiding under their desks. It is understandable that the bulk of the dental profession has given up. It’s been proven over and over there is no money to be made in Medicaid dentistry, if provided ethically. Add government corruption and ineptitude to the mix and it’s like the sadistic relationship between the addict, and their co-dependent enabler; life and death danger to both.

Tuesday, March 12, 2013

WFAA’s dental fraud investigations recognized and lauded by Forbes

Ending White House Tours Instead Of Ending Medicare And Medicaid Fraud -

Merrill Matthews, Contributor
March 7, 2013


“White House Tours will be canceled effective Saturday, March 9, 2013 until further notice,” according to a White House email.  Meanwhile, billions of dollars pour out of Medicare and Medicaid because of waste and fraud.  Indeed, eliminating Medicare and Medicaid fraud, rather than White House tours, would offset the sequester cuts for the next decade.

two idiotsI don’t know how much money President Obama thinks it saves by canceling White House tours, though I’ll bet it’s a lot less than one of his golfing trips on Air Force One, which costs about $180,000 an hour to fly.

But we do have several estimates of how much Medicare and Medicaid fraud cost.  Typical estimates, which have been echoed by the Obama administration, put the figure in the $60 billion a year range for each program.

A study by the Rand Corporation pegged Medicare and Medicaid fraud at about $98 billion in 2011, roughly equal to the future annual budget cuts (actually, reductions in the rate of growth) imposed by the sequester.

The Government Accountability Office’s (GAO) most recent estimate for Medicare, released in February, claimed there was a total of $44 billion in improper payments in 2012.  That figure is a little lower than the $48 billion for 2010.

Not all of the GAO calculation is fraud.  It includes overpayments and underpayments, unnecessary services, coding errors and other problems.  And there is fraud that isn’t detected by the GAO report.  But you get the idea; it’s a big problem and getting bigger as criminals and the mob get more brazen in their efforts.  For example:

Wednesday, August 01, 2012

This week’s second most stupid story, with no point whatsoever.


July 30, 2012|By Tim Darragh, The Morning Call


Medicaid cuts mean less dental care for poor

Allentown endodontist is driven to retirement as Pennsylvania eliminates root canal coverage through Medicaid.

Jerome Grossinger has closed his endodontistry practice (root canals) because the state Medicaid program will no longer cover the procedure for anyone over 21. Behind Dr Grossinger are empty patient folder racks that used to be filled with clients information. Photo taken July 26, 2012Jerome Grossinger has closed his endodontistry practice (root canals)… (BEN MORRISON, THE MORNING…)



The phone is still ringing off the hook in Dr. Jerome Grossinger's quarters in an office building in Allentown's West End.

But his office isn't taking appointments.

The 77-year-old endodontist, a dentist who specializes in root canals, has relieved his patients' excruciating pain for the past 42 years, focusing in recent years on low-income and disabled people covered by Medicaid.

He is 77 for heavens sake!!!  The way this story is presented you would think he was in his prime and had a wife and 4 little ones at home – two still in diapers.

But instead of treating the 15-20 new patients he'd typically see every week, Grossinger recently sat alone in his office and scanned years of patient records in bags, furniture stacked in the waiting room and the odds and ends of four decades of health care being readied for the Dumpster.

Grossinger is reluctantly calling it quits.

"I cannot believe this is happening to me," he said, recently. "I'm really in a daze about this."

Seriously!!!??  Look, Dr. Grossinger is probably a great guy and has had a thriving business for many many years, but to make him the example of Medicaid cuts??!!


Monday, February 13, 2012

Dentist admits filing false Medicaid reports | The News Journal |


WILMINGTON — Prominent Wilmington dentist Marieve Rodriguez admitted to 10 misdemeanor counts of filing false Medicaid reports today in exchange for state prosecutors dropping 19 felony counts of health care fraud.

In addition Rodriguez, who operates Gentle Care Family Dentistry on Gilpin Avenue, will pay a $100,000 fine, repay $72,000 to the state’s Medicaid program and $50,000 to cover the costs of prosecution.

She also agreed to have her license to practice medicine suspended for a year and to not participate in the state’s Medicaid program -- should she get her license back -- for at least five years.

Tuesday, January 31, 2012

Dentist who used paper clips in root canals gets one year in jail - Crimesider - CBS News


(CBS/AP) FALL RIVER, Mass. - Dr. Michael Clair, a former dentist who substituted paper clips for stainless steel posts in root canals, was sentenced to one year in jail on Monday.

Clair pleaded guilty earlier this month to charges including assault and battery, illegally prescribing medication, witness intimidation and defrauding Medicare of $130,000.

Prosecutors say that Clair sometimes used pieces of paper clips while performing root canals. This caused infections and other problems in patients.

One woman said her teenage son's tooth turned black and had to be removed after Clair gave him a root canal in 2005.

"He put my kids in pain for months ... I hope he rots there," said Brenda Almeida after Judge Richard Moses sentenced Clair to a year in the Bristol County House of Correction.

Dentist Charged with Medicaid Fraud - Holmdel, NJ Patch

An announcement from the Office of the New Jersey Attorney General

Attorney General Jeffrey S. Chiesa announced that a Monmouth County dentist has been indicted for allegedly submitting false claims to the Medicaid program.

Ping Cai, 49, of Holmdel, a licensed dentist whose practice is located in Hazlet, was charged with second-degree health care claims fraud and two counts of third-degree Medicaid fraud.

The Monmouth County grand jury indictment alleges that between Jan.1, 2007 and Jan.1, 2010, Cai fraudulently billed the Medicaid Program for dental service purportedly rendered to Medicaid recipients. 

It is alleged that Cai submitted fraudulent claims for payment from Medicaid for relining and rebasing of dentures and filling of cavities when those dental services were not rendered. 

Friday, January 27, 2012

Centre County Dentist Facing Insurance Fraud Charge |


January 27, 2012 at 6:46 AM

HARRISBURG, PA – Attorney General Linda Kelly announced criminal charges have been filed against a Centre County dentist accused of submitting more than $52,000 in false insurance claims following a joint investigation with the Federal Bureau of Investigations (FBI) State College office. 

Kelly identified the defendant as Dr. Jamshid Assadinia, 53, of 1764 Cambridge Drive, State College, Centre County. Dr. Assadinia owns and operates Jamshid Assadinia DDS,300 South Allen St., State College.

Kelly said Assadinia allegedly submitted insurance claims for dental procedures that he never performed and then billed the insurance companies more than $52,000 under the names of several different patients.

Tuesday, January 10, 2012

USDOJ: US Attorney's Office - Eastern District of Virginia


Alexandria Dentist Pleads Guilty to Health Care Fraud


January 10, 2012

ALEXANDRIA, Va. –Tuan Vu, 43, of Annandale, Va., pleaded guilty today to fraudulently billing insurance providers hundreds of thousands of dollars for dental services that he did not provide to his patients. 

            Neil H. MacBride, United States Attorney for the Eastern District of Virginia, and James W. McJunkin, Assistant Director in Charge of the FBI’s Washington Field Office, made the announcement after the plea was accepted by United States District Judge Liam O’Grady. 

            Vu was charged today by criminal information with health care fraud, and he faces a maximum penalty of 10 years in prison when he is sentenced on May 4, 2012. 

In a statement of facts filed with his plea agreement, Vu admitted to committing health care fraud from at least January 2007 to September 2011.  Vu is the owner of Cosmetic & Family Dentistry, PLLC, a dental practice located in Alexandria, Va.  During the time of his health care fraud scheme, Vu consistently billed dental insurance providers for services that he did not provide his patients.  As a result of Vu’s offense, at least 10 private insurance providers suffered more than $400,000 in losses.  Dr. Vu’s conduct also resulted in a substantial loss to the federal government and the Commonwealth of Virginia, including $87,389 to the Federal Employee Health Benefits Program and $180,048 to the Virginia Medicaid program.

            This case was investigated by the FBI’s Washington Field Office.  Assistant United States Attorney Chad Golder is prosecuting the case on behalf of the United States.

A copy of this press release may be found on the website of the United States Attorney's Office for the Eastern District of Virginia at  Related court documents and information may be found on the website of the District Court for the Eastern District of Virginia at or on

USDOJ: US Attorney's Office - Eastern District of Virginia

Friday, November 04, 2011

Dr. Tung Thai Nguyen Pleads Guilty To Health Care Fraud-Greensboro, NC

  NC Dental Board Action 2009

Silva and Silva DMD Pllc 
(used to be Nguyen, Silva and Silva, P.A. D.M.D –dissolved 1-12-2011)
Silva and Silva, LLC
Dr. Enrico Silva
Dr. Ha Hguyen Silva
1505 West Lee Street
Greensboro, NC  27403

November 4, 2011
From WMFY News

Greensboro, NC-- A Greensboro dentist has admitted to health care fraud. 

Thursday, the US Attorney's Office accepted a plea deal with Tung Thai Nguyen. Nguyen pleaded guilty to health care fraud charges in connection with false claims submitted to Medicaid.

Dr. Nguyen, 40, pleaded guilty, in A Winston-Salem federal court room,  to two counts of violating health care fraud and one count of violating 18 false entries in a matter involving a health care benefit program.

According to documents filed in Court, Dr. Nguyen submitted claims to the Medicaid program for dental restorations not actually performed. Dr. Nguyen also submitted a claim to the Medicaid program for the installation of one type of partial denture when he actually furnished a less expensive and different partial denture to the patient.

Nguyen will be sentence in February 2012. He faces the maximum possible penalty for a health care fraud violation, which is not more than ten years imprisonment, a maximum fine of $250,000, and a term of supervised release not to exceed three years. The maximum possible penalty for a false entry violation is not more than five years imprisonment, a maximum fine of $250,000, and a term of supervised release not to exceed three years.

The Court may also order the defendant to pay restitution to the health care benefit program.

The case was investigated by the Health and Human Services Office of Inspector General and the North Carolina Attorney General's Medicaid Investigations Unit and prosecuted by Assistant United States Attorney Robert Hamilton.

Tuesday, October 25, 2011

Real dentists sharing real thoughts about sealants, dental mills, waste and fraud

Dentist 1:

It’s all designed to fool the taxpayer.  Politian's get into trouble for overspending.  They cut services, in this case Medicaid reimbursement fees for dental treatment. To keep the special interest happy, they agree to cover another procedure, everyone’s happy.

I work in an office (corporate mill) that takes Medicaid- MassHealth-in my state. which covers sealants on primary molars.  In my opinion, I think sealants on second primary molars (first primary, very rare) are beneficial in only a small percentage of cases; high risk, deep grooves, ability to obtain good isolation, etc.

Here's what I find troublesome and wasteful from a taxpayers point of view.
- We routinely seal all primary molars up to the age of 8, even on low risk patients with shallow grooves
-  90% of the time dental assistants place them alone with poor isolation.
I only do sealants when I have good isolation.  95% of the time I use my Isolite.  
With my criteria, I rarely seal primary molars. 
The dentists who do treatment plan sealants on a 3 year old, that will not even remain still for an exam or cleaning are wasting tax dollars in my opinion.  I do see pressure for assistants to do them from the corporate headquarters.  Corporate heads want a “sealant” report daily.  That irks the hell out of me.  It irks me even more when the dentist is not busy at all and still let's the assistant do them alone!

Monday, September 26, 2011

The Real Cheaters

Boston Herald Monday September 26, 2011

The cheating done by food stamp recipients is peanuts compared to vendor fraud (“Life’s a beach on EBT street,” Sept. 22).

Most fraud is done by pharmacies, doctors, dentists, nursing homes, hospitals and sellers of medical equipment. The government recovered $2.5 billion in overpayments for Medicare in 2009 as the Obama administration focused attention on fraud enforcement efforts in the health industry.
Click here to read the full story
The Real Cheaters