Dentists Targeted for Billing Medicaid for Dead Patients; Okay to Treat Dead Patients, You Just Can't Bill for It

Wednesday, September 9, 2015
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Two South Florida dentists are at the center of a fraud investigation after, among other things, allegedly billing Medicaid for unnecessary dentures for their patients, according to the Florida Attorney General's Office. Married couple Marino Vigna and Beth Reinstein operate Sunrise Dental Clinic in Fort Lauderdale. They have not yet been arrested or charged, however, their billing practices are reportedly under investigation. According to the South Florida Sun Sentinel, the office of Florida's Attorney General is focusing on the clinic's submission of Medicare claims dating back to Jan. 1, 2010.


Hundreds of Elderly Patients Affected.

Vigna and Reinstein allegedly billed Medicaid for dentures for patients who had no need for false teeth. According to investigator Alexander Perez, many of the couple's patients were "already deceased or unable to be interviewed due to physical and/or psychological disabilities." Other alleged patients suffered from dementia and could not recall if they had previously received any services from Dr. Vigna.

Medicaid paid a $1,198 claim for a 100-year-old woman residing in a senior care facility. Vigna billed for the extraction of 11 teeth and upper and lower dentures. When investigators interviewed the woman's son, it was revealed that she never had any teeth extracted by Vigna and her dentures were obtained 12 years ago in another state. Another alleged patient had no need for dentures as the patient had long been restricted to a liquid diet.


Other Fun Facts (Allegations).

The clinic reportedly billed for services provided to patients while Vigna and Reinstein were vacationing out of the country. The Bureau of Immigration and Customs Enforcement (ICE) confirmed that the couple were in the Netherlands, Bahamas, Paris and Sweden, on the dates in question. Red flags were raised as clinic employees revealed to investigators that the dental office closes when Vigna goes on vacation.

Furthermore, some patients reportedly treated by the clinic were deceased at the time of their services, yet the clinic still billed Medicaid.


How Much Did the Alleged Fraud Cost Medicaid?

At this time, an estimate of the total alleged fraud cost is not available. The Sun Sentinel revealed, however, that the clinic was reportedly paid nearly $10,000 for services provided to Medicaid patients who were allegedly treated while the couple was on vacation in 2012.

To learn more about the large crackdowns on Medicaid fraud and how it may affect you, read one of our past blogs here.

To read about the oversight of the integrity of the Medicaid program click here.


Editor's Comments.

As I've always said, you can treat dead people as much as you want. Just don't try to bill Medicare or Medicaid for the treatment.


Comments?

Do you think harsher punishments are the key to counteracting Medicaid fraud? Leave any thoughtful comments below.


Contact Health Law Attorneys Experienced in Handling Medicaid Audits, Investigations and Other Legal Proceedings.

Medicaid fraud is a serious crime and is vigorously investigated by the state MFCU, the Agency for Health Care Administration (AHCA), the Zone Program Integrity Contractors (ZPICs), the FBI, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (DHHS). Often other state and federal agencies, including the U.S. Postal Service (USPS), and other law enforcement agencies participate. Don’t wait until it’s too late. If you are concerned of any possible violations and would like a confidential consultation, contact a qualified health attorney familiar with medical billing and audits today. Often Medicaid fraud criminal charges arise out of routine Medicaid audits, probe audits, or patient complaints.
 
The Health Law Firm’s attorneys routinely represent physicians, dentists, orthodontists, medical groups, clinics, pharmacies, assisted living facilities (AFLs), home health care agencies, nursing homes, group homes and other healthcare providers in Medicaid and Medicare investigations, audits and recovery actions.

To contact The Health Law Firm please call (407) 331-6620 or visit our website at www.TheHealthLawFirm.com.


Sources:

Alanez, Tonya. (Aug. 12, 2015). "Dentists target of false-teeth inquiry." Orlando Sentinel.


About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law.  He is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in the Orlando, Florida area.  www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.


KeyWords: dentist, dental clinic dental practice, Medicaid, Medicaid fraud, Medicaid investigation, Medicaid claims, fraudulent claims, health care fraud, Medicaid billing, Attorney General senior health care Medicaid reimbursements health law firm, The Health Law Firm reviews


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9/9/2015

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