Update February 2021:
Dr, Lookhart was sentenced to 12 years in prison for is convictions on charges including Medicaid fraud, embezzlement, reckless endangerment and unlawful dental acts. The State of Alaska is also seeking restitution of $2.2 million.
Original Story:
Many of us have heard about Dr. Seth Lookhart, the Alaska dentist who was on video showing him riding a hoverboard while extracting a tooth on a sedated patient.
As outlandish as this activity is, there seems to be more to the story. Dr. Lookhart is also accused of diverting over $250,000 from Alaska Dental Arts, the practice where he was working as an associate.
Information gathered by investigators from the State of Alaska's Medicaid Fraud Control Unit in connection with some alleged Medicaid billing improprieties for IV sedation also suggested a plot between Dr. Lookhart and his office manager, Shauna Leigh Cranford, to bill some of their IV sedation work through a separate billing number and thus deprive the owners of the practice from their share of this revenue.
Shauna Cranford, who has also used the surnames Billings and Smith, was charged in 2017 for assault on a police officer.
The State's investigators obtained a search warrant to seize and copy the phones of Dr. Lookhart and Ms. Cranford, and found the following exchange of text messages where the intent to divert some of the revenue from the practice is quite clear.
Ms Cranford entered a guilty plea in October 2019 for pushing excessive and often needless intravenous sedation for Medicaid patients. Her sentencing is scheduled for February 3, 2020.
Seth Lookhart's text messages
12/29/2015 8:55:18 AM(UTC-9), - (Seth Lookhart)
Weird side question but could we start running some sedation through my personal medi number
Status: Read
12/29/2015 8:55:23 AM(UTC-9), - (Shauna Cranford)
I agree. We are not here to kick start ADA as an IV practice and provide all of the leg work
Status: Sent
12/29/2015 8:55:42 AM(UTC-9), - (Shauna Cranford)
Yes we could
Status: Sent
12/29/2015 8:56:32 AM(UTC-9), - (Shauna Cranford)
I can send claims through their website for Lookhart Dental LLC
Status: Sent
12/29/2015 8:57:42 AM(UTC-9), - (SL)
I know it might prevent me from coming at them for back taxes with a law suit but it might be worth it
Status: Read
12/29/2015 8:58:12 AM(UTC-9), - (SL)
Our office production would drop and it would draw far less attention to the office
Status: Read
12/29/2015 8:58:25 AM(UTC-9), - (SL)
Will they be able to track it
Status: Read
12/29/2015 8:58:33 AM(UTC-9), - (SL)
I want it untraceable
Status: Read
12/29/2015 9:03:36 AM(UTC-9), - (Shauna Cranford)
They can't look at your claims at all and the check would go to your house. If you are billing procedures as well as the sedation, only bill under your LLC for ones that don't require auth
Status: Sent
12/29/2015 9:05:17 AM(UTC-9), - (Seth Lookhart)
Like sedation
Status: Read
12/29/2015 9:06:11 AM(UTC-9), - (Seth Lookhart)
It would be only sedation and probably not all of them
Status: Read
12/29/2015 9:06:21 AM(UTC-9), - (Seth Lookhart)
How would it look through dentrix
Status: Read
(Note: Dentrix was the internal tracking program used by the clinic)
12/29/2015 9:11:10 AM(UTC-9), - (Shauna Cranford)
We just wouldn't flag them as sedation
Status: Sent
12/29/2015 9:11:37 AM(UTC-9), - (Shauna Cranford)
And not put in the sedation charges
Status: Sent
12/29/2015 9:11:57 AM(UTC-9), - (Shauna Cranford)
So it would look like you're doing less sedation
Status: Sent
12/29/2015 9:18:01 AM(UTC-9), - (Shauna Cranford)
I'm surprised the power hasn't gone out
Status: Sent
12/29/2015 9:31:08 AM(UTC-9), - (Seth Lookhart)
I think that's what I'd like to do
Status: Read
12/29/2015 9:31:50 AM(UTC-9), - (Seth Lookhart)
Even if we only do 50% of the sedations it will drop their production to a more "normal/reasonable" level
Status: Read
12/29/2015 9:32:34 AM(UTC-9), - (Shauna Cranford)
I would keep a separate copy of the sedation records that you bill under yourself
Status: Sent
12/29/2015 9:32:46 AM(UTC-9), - (Seth Lookhart)
Sure
Status: Read
12/29/2015 9:32:57 AM(UTC-9), - (Shauna Cranford)
I can photocopy them and give them to you to store off site
Status: Sent
12/29/2015 9:33:33 AM(UTC-9), - (Seth Lookhart)
I guess they could catch on if they manually went through charts and saw scanned record and compared to the ledger and they weren't showing there
Status: Read
Read: 12/29/2015 9:33:35 AM(UTC-9)
12/29/2015 9:34:11 AM(UTC-9), - (Shauna Cranford)
I don't know that they are that smart
Status: Sent
12/29/2015 9:34:49 AM(UTC-9), - (Seth Lookhart)
I'm sure they aren't
Status: Read
12/29/2015 9:35:42 AM(UTC-9), - (Seth Lookhart)
And as far as sedation goes it's a pretty sure fire payment correct
Status: Read
12/29/2015 9:35:56 AM(UTC-9), - (Shauna Cranford)
As long as they are eligible
Status: Sent
12/29/2015 9:36:22 AM(UTC-9), - (Shauna Cranford)
It pays out right away
Status: Sent
12/29/2015 9:51:49 AM(UTC-9), - (Seth Lookhart)
How hard is it to set up?
Status: Read
12/29/2015 9:52:01 AM(UTC-9), - (Seth Lookhart)
And what's the fee for 9243?
Status: Read
12/29/2015 9:52:24 AM(UTC-9), - (Shauna Cranford)
Set up what? You are already set up
Status: Sent
12/29/2015 9:52:45 AM(UTC-9), - (Seth Lookhart)
So it's just start billing?
Status: Read
12/29/2015 9:52:50 AM(UTC-9), - (Shauna Cranford)
I would just have to login to their website and submit the codes manually through their portal
Status: Sent
12/29/2015 9:53:03 AM(UTC-9), - (Seth Lookhart)
Can they track that?
Status: Read
12/29/2015 9:53:45 AM(UTC-9), - (Shauna Cranford)
$170.76
Status: Sent
12/29/2015 9:53:56 AM(UTC-9), - (Shauna Cranford)
They meaning BS?
Status: Sent
12/29/2015 9:54:08 AM(UTC-9), - (Shauna Cranford)
BS cannot track it
Status: Sent
(Note -- BS is an acronym for the names of the owners of the practice_
12/29/2015 9:56:39 AM(UTC-9), - (Seth Lookhart)
Yeah
Status: Read
12/29/2015 9:56:57 AM(UTC-9), - (Seth Lookhart)
Or anyone else
Status: Read
12/29/2015 9:57:13 AM(UTC-9), - (Shauna Cranford)
Just Medicaid would know
Status: Sent
12/29/2015 9:57:42 AM(UTC-9), - (Shauna Cranford)
The RA would get mailed to your house
Status: Sent
12/29/2015 9:57:57 AM(UTC-9), - (Seth Lookhart)
Sure
Status: Read
12/29/2015 9:58:00 AM(UTC-9), - (Seth Lookhart)
Let's do it
Status: Read
12/29/2015 9:58:41 AM(UTC-9), - (Seth Lookhart)
Do we incrementally reduce volume or take a decent cut?
Status: Read
12/29/2015 10:01:19 AM(UTC-9), - (Shauna Cranford)
That's up to you.
Status: Sent
12/29/2015 10:02:26 AM(UTC-9), - (Shauna Cranford)
A decent cut would draw some attention but you can have some excuse
Status: Sent
12/29/2015 10:03:03 AM(UTC-9), - (Shauna Cranford)
An incremental reduction would likely go unnoticed until a certain level
Status: Sent
12/29/2015 10:05:40 AM(UTC-9), - (Shauna Cranford)
Attrition
Status: Sent
12/29/2015 10:05:47 AM(UTC-9), - (Seth Lookhart)
Sure
Status: Read
12/29/2015 10:06:07 AM(UTC-9), - (Seth Lookhart)
I would say our numbers shouldn't not increase
Status: Read
12/29/2015 10:07:41 AM(UTC-9), - (Shauna Cranford)
Lol it actually reminds me about a rant LJ had about the maid stealing his socks and undershirts. He compared it to attrition.
Status: Sent
12/29/2015 10:07:59 AM(UTC-9), - (Shauna Cranford)
It was funny. The rant went on for like an hour
Status: Sent
12/29/2015 10:08:52 AM(UTC-9), - (Shauna Cranford)
Yes I agree or the numbers should be around the average for sedation. Like $40-$50k
Status: Sent
12/29/2015 10:09:26 AM(UTC-9), - (Shauna Cranford)
I would throw out our high of near $80k
Status: Sent
12/29/2015 10:10:47 AM(UTC-9), - (Seth Lookhart)
I would say within six months 50% get billed out under the cartel
Status: Read
(Note: Cranford and Lookhart often refer to their business and practices as “the cartel”)
12/29/2015 10:11:00 AM(UTC-9), - (Seth Lookhart)
Reasonable?
Status: Read
12/29/2015 10:11:26 AM(UTC-9), - (Shauna Cranford)
Sounds good
Status: Sent
12/29/2015 10:12:12 AM(UTC-9), - (Shauna Cranford)
I'll check out the portal a little today. I've never used it for sending claims but was trained on it by Joan. It was simple enough
Status: Sent
12/29/2015 10:13:55 AM(UTC-9), - (Seth Lookhart)
Lol
Status: Read
12/29/2015 10:13:57 AM(UTC-9), - (Seth Lookhart)
Ok
Status: Read
12/29/2015 10:15:37 AM(UTC-9), - (Seth Lookhart)
I would say we keep sedations around 25 a month under ak dental arts
Status: Read
12/29/2015 10:16:19 AM(UTC-9), - (Seth Lookhart)
And still keep a record on the sedation excel but may star those billed under the cartel
Status: Read
12/29/2015 10:17:01 AM(UTC-9), - (Shauna Cranford)
That's around 20 sedations to ADA. So like month 1
Status: Sent
12/29/2015 10:19:13 AM(UTC-9), - (Seth Lookhart)
Wait what?
Status: Read
12/29/2015 10:20:22 AM(UTC-9), - (Seth Lookhart)
Over the last 6 months we have averaged around 40 sedations a month of say we keep around 25 going to BS and the remaining 15 to the cartel
Status: Read
12/29/2015 10:20:59 AM(UTC-9), - (Shauna Cranford)
Got it. I thought you were talking $25k
Status: Sent
12/29/2015 10:21:26 AM(UTC-9), - (Seth Lookhart)
Or perhaps better to do a percentage so that it will naturally eb and flow
Status: Read
12/29/2015 10:22:07 AM(UTC-9), - (Seth Lookhart)
And I wouldn't have a day sheet on the cartel cases correct?
Status: Read
12/29/2015 10:22:50 AM(UTC-9), - (Shauna Cranford)
Correct. But I would make something so that tracking claims would be easier
Status: Sent
12/29/2015 10:23:18 AM(UTC-9), - (Shauna Cranford)
So you would have a day sheet. Just not a dentrix one
Status: Sent
12/29/2015 10:23:51 AM(UTC-9), - (Seth Lookhart)
Sure
Status: Read
12/29/2015 10:41:33 AM(UTC-9), - (Seth Lookhart)
Do you think 40% of sedations is reasonable and not noticeable
Status: Read
12/29/2015 10:41:50 AM(UTC-9), - (Seth Lookhart)
Start with 15% for jan
Status: Read
12/29/2015 10:42:09 AM(UTC-9), - (Seth Lookhart)
Then 25 for feb
Status: Read
12/29/2015 10:42:16 AM(UTC-9), - (Seth Lookhart)
Then 35 for March
Status: Read
12/29/2015 10:42:25 AM(UTC-9), - (Seth Lookhart)
And 40 for April and forward?
Status: Read
12/29/2015 10:42:30 AM(UTC-9), - (Seth Lookhart)
Looks great
Status: Read
12/29/2015 10:42:32 AM(UTC-9), - (Seth Lookhart)
Thanks
The Medicaid Fraud Control Unit investigators determined that a total of $250,686 was billed to Medicaid and sent directly to Dr. Lookhart's home address. Based on the 70% share that belonged to the practice, this suggests embezzlement of about $175,000.
Dr. Lookhart was convicted on 46 counts, including felony medical assistance fraud and scheming to defraud, as well as misdemeanor counts of illegally practicing dentistry and reckless endangerment.
For an excellent discussion of the many disturbing aspects of this affair, please see Dr. Michael Davis' article in Dentistry Today titled "Hoverboard Dentist” Found Guilty of Medicaid Fraud". It can be accessed here -- https://www.dentistrytoday.com/news/todays-dental-news/item/5901-hoverboard-dentist-found-guilty-of-medicaid-fraud
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