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Cherie R. Dillon, 62, will spend five years in prison for completing dental procedures that legally could only be performed by a dentist.
Dillon drilled and pulled teeth, provided patients at her Payette office with fillings and dentures, and offered other procedures that went far beyond her license as a dental hygienist. Dillon did not attend dental school and did not have a license beyond a hygienist’s.
At the same time, she billed patients for dental hygiene services performed without the supervision and direction of a dentist, required under state law and licensing requirements.
Under a preliminary order, Chief U.S. District Judge B. Lynn Winmill ordered Dillon to forfeit $847,016 in illegal proceeds and to pay $549,605 in restitution. A final order is expected to be issued following a hearing Aug. 9.
Dillon pleaded guilty to two dozen counts of health care fraud and an equal number of counts of aggravated identity theft. Her change of plea came in January, after four days of trial.
Dillon founded her Payette practice, Dental Healthcare With Heart, in August 2005. She hired dentists to work for her on a part-time basis in exchange for sharing one-quarter to one-third of the money she took in from health care benefit providers for services provided by the dentists.
Dillon took advantage of the condition of one of her contract dentists, Dr. Theodore Fricke, who was suffering from severe health problems that required in-home health care. In late 2010, Fricke’s physician certified he was fully disabled for the purpose of disability insurance.
Dillon fraudulently billed Medicaid and insurance companies for services she said were performed by Fricke between 2010 and 2013, authorities said. She billed $1.5 million during those years, according to court documents.
Prosecutors introduced evidence that Dillon renewed Fricke’s dental license and a license for prescribing controlled substances. She even completed online continuing education requirements for Fricke.
Dillon carried on a ruse that Fricke continued to practice at Dental Healthcare With Heart, telling other contract dentists that Fricke worked on a day they weren’t in the office.
Prosecutors said Dillon stamped medical records, letters and billing documents with Fricke’s signature stamp.
Dillon deposited “substantial” amounts of cash into retirement accounts for her and her husband. The amounts, prosecutors said, “exceeded the amount paid to any contract dentist” performing actual dental procedures at the practice.
If insurance companies had known treatments were billed by a dental hygienist working outside the scope of her license, they would not have paid for the treatments.
The Idaho State Board of Dentistry pressured Dillon into surrendering her dental hygienist license in June 2016, after the allegations surfaced.
The case was investigated by the Health and Human Services Office of Inspector General, with assistance from the Idaho Attorney General’s Medicaid Fraud Control Unit.
“The U.S. Attorney’s Office and its federal and state law enforcement partners are committed to vigorously pursuing health care benefit fraud,” Acting U.S. Attorney Rafael Gonzalez said.
Read more here: http://www.idahostatesman.com/news/local/crime/article154852059.html#storylink=cpy