Idaho hygienist sentenced to five years in prison for health care fraud

Cherie R. Dillon

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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

 

WA dental hygienist charged with cleaning up in $81,000-plus workers’ comp scam

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Seattle – A dental hygienist faces a felony theft charge after she was caught working while receiving more than $81,000 in workers’ compensation disability payments.

Shari Lee Kristiansen, 53, of Lynnwood, faces one count of first-degree theft. She’s slated to be arraigned in King County Superior Court on Thursday, Nov. 3.

The Washington Attorney General’s Office is prosecuting the case based on an investigation by the Department of Labor & Industries (L&I), which administers the state workers’ compensation system.

A routine comparison of L&I and state Employment Security Department records turned up the alleged double-dipping.

“We have checks in place to catch workers’ comp thieves,” said Elizabeth Smith, assistant director of L&I’s Fraud Prevention & Labor Standards. “If you’re even thinking of trying to scam the system that helps legitimately injured workers, forget about it!”

Misrepresentations to doctors

Kristiansen filed a claim with L&I in March 2013, saying she injured her thumbs and hands while working as a dental hygienist for several dentists in King and Snohomish counties. However, charging papers state, she misrepresented her activities and the extent of her injuries to her physicians, who relied on her statements to tell L&I that she couldn’t work as a dental hygienist.

L&I provided benefits to Kristiansen, including cash payments to make up for part of her lost wages. To confirm she was eligible, Kristiansen repeatedly stated on official forms that she couldn’t work, and wasn’t working, because of the on-the-job injury.

But an L&I investigation later found she continued to work for various dentists from the time she was injured through May 2013, and then for 11 months starting in late October 2014, charging papers said.

In all, L&I paid nearly $57,000 in wage-replacement checks to Kristiansen, more than $19,000 for medical benefits and nearly $6,000 for vocational counseling.

Content retrieved from: http://lni.wa.gov/News/2016/pr161102a.asp

Embezzlement isn’t always about stealing money — sometimes it is information

Kennewick, Washington police accuse 3 of dental office prescription drug scheme

Two employees of a Kennewick dental office are accused of pulling off a sophisticated scheme involving at least 167 forged prescriptions.

Nicole Bernice Polus and Chareise Louise Raugust, along with her fiance, Miljan Ignjatic, allegedly wrote, called in or picked up fraudulent prescriptions in the Tri-Cities during a four-year period, police said.

“There were so many names … including fictitious names,” Kennewick police Detective Rick Runge told the Herald. “It is just so large, we just went with the suspects’ names and family” to try to track the forgeries.

Polus and Ignjatic made their first appearances Thursday in Benton County Superior Court and pleaded innocent to several charges of obtaining a controlled substance through fraud.

Polus, 40, faces an April 9 trial on eight charges of fraudulently obtaining Lorcet and Vicodin. The charges include the aggravating factor that she used a position of trust to commit the crime. Polus was a dental hygienist in William Craig Stout’s dental office.

Ignjatic, 34, is charged with six counts of obtaining Lorcet, hydrocodone and diazepam through fraud. His trial is also set for April 9.

Raugust, who was Stout’s office manager, pleaded innocent to one count of obtaining a controlled substance — hydrocodone — through fraud, with the aggravating factor that she used a position of trust to commit the crime.

She also was in court Thursday. Her trial is April 9.

Kennewick police began investigating the case in September after getting an anonymous tip through Tri-Cities Crime Stoppers claiming that employees at Stout Family Dental were embezzling money, forging prescriptions and providing free dental care.

Runge was assigned to investigate the tip and contacted Stout, who “was shocked, to say the least.”

Through the investigation, Runge contacted four pharmacies and found 167 forged prescriptions that had allegedly been authorized by Stout and Navdeep Virk, who owned the dental practice before Stout bought it in October 2010.

Stout bought new software for prescriptions and one suspect was using the old system to write various prescriptions for herself, her husband and other people, Runge said.

He said the other suspect was “just forging prescriptions and calling them in.”

According to court documents, Polus called in several unauthorized prescriptions in the name of herself, her relatives, Raugust and Raugust’s relatives. Stout and Virk were contacted by police and both said they did not authorize the medications.

Raugust’s charge stems from two prescriptions that were called in for her son, Jaden Raugust-Gonzales, documents said.

Raugust-Gonzales told Runge that he asked his mother if she could get him prescriptions for a toothache. She asked Stout, but Stout said he would not approve the prescription unless he was able to see Raugust-Gonzales in the office first, documents said. Raugust-Gonzales never was examined.

Ignjatic is accused of picking up forged prescriptions that had been called in to pharmacies in his name.

Runge credited Tyler Varnum, with the state Board of Pharmacy, with helping him understand the prescription process as he investigated the case. Varnum came to the Tri-Cities twice to go to pharmacies with Runge, he said.

Runge said he traced the scheme back to 2007, but because many fictitious names were used, it was difficult to track them all down to try to connect them back to the suspects.

“Just trying to get a handle on it and tracking all the names” was the biggest challenges to the investigation, he said.

This is not the first time, however, that Polus allegedly called in fraudulent prescriptions. In 2008, she self-reported to the state Department of Health, her employer and police that she called in three unauthorized prescriptions for diazepam, according to Department of Health records.

Polus, who has had a state dental hygiene license since 1997, admitted the violations after the allegations surfaced during her divorce proceeding, records said.

Richland police investigated the prescription fraud allegations between June and December 2005, said Capt. Mike Cobb. It was reported by Polus on June 10, 2008.

The police report was forwarded to the Benton County Prosecutor’s Office, but no charges were filed. Benton County Prosecutor Andy Miller said the report indicated that Polus was very cooperative and remorseful, and the statute of limitations had passed.

Polus was, however, placed on a two-year probation by the state Department of Health after she cooperated with the investigation and expressed a “willingness to undergo a substance abuse assessment,” records show.

Polus was required to get a drug evaluation and complete a program, if recommended, retake the dental hygienist drug and law exam within six months, and pay a $1,000 reimbursement to the Dental Hygienist Program.

It is not known if Polus followed through with the requirements of her probation, but no other action has been taken against her by the health department, according to online records.

Her dental hygiene license was renewed Oct. 28, 2011.


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Content retrieved from: http://www.tri-cityherald.com/news/local/crime/article32043666.html

Connecticut dental hygienist facing larceny and fraud charges

christine-zampedri

WEST HAVEN, Conn. (WTNH) — A West Haven woman working as a dental hygienist in New Canaan was arrested Wednesday accused of illegally collecting roughly $18,000 in unemployment compensation funds.

Christine Zampedri, 49, of West Haven, was charged with larceny and unemployment compensation fraud. According to the arrest warrant affidavit, Zampedri fraudulently collected approximately $17,860 in unemployment benefits from January through August 2013, while she was working as a dental hygienist in New Canaan.

The arrest is a result of an investigation into a complaint by the Connecticut Department of Labor. Her arrest was made by Inspectors from the Unemployment Compensation Fraud Unit in the Office of the Chief State’s Attorney, according to the State Department of Criminal Justice.

Zampedri was released on a $10,000 non-surety bond and is scheduled to appear in New Britain Superior Court on Aug. 30, 2016.


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Content retrieved from: http://wtnh.com/2016/08/24/dental-hygienist-who-illegally-collected-unemployment-arrested/

Two employees in New Jersey dental office plead guilty in theft of $200,000

arlene-marchese-karen-wright

Two former employees of a Haledon dental office admitted on Monday that they stole $200,000 from their employer.

Arlene Marchese, 35, of Wayne, and Karen Wright, 44, of Wyckoff, worked at Belmont Dental Associates for more than a decade, beginning in the late 1990s.

Marchese, who was the office manager, and Wright, a dental hygienist, said Monday in state Superior Court in Paterson that they diverted insurance payments to their employer for six years, from 2005 to 2011.

In separate guilty pleas before Judge Greta Gooden Brown, the two women admitted that the payments were made by insurance companies in a series of checks for services rendered at the dental office.

Marchese and Wright said they were authorized to receive those checks and deposit them in the business account of Belmont Dental Associates, but instead deposited the money in another account and used the money for their own purposes.

The two women were charged in 2012 after Dr. Dominick Lembo, who owns the dental office, called an insurance company to inquire about payments that he should have received, and eventually discovered the thefts.

As part of the plea deal, Marchese and Wright agreed to make restitution of $200,000 and will receive probation when they are sentenced May 2, said Jay McCann, an assistant Passaic County prosecutor.

The agreement requires the two women to make a payment of $20,000 each on Monday and $5,000 each on their day of sentencing, McCann said. They will also pay $1,000 a month during their probation until the remaining balance is paid off, he said.

Defense attorneys Robert Galluccio and Mark Musella told the judge that the $20,000 that each defendant is required to pay on Monday has already been placed in attorney trust accounts and that Lembo will receive the payment on the same day.

Lembo, who attended the hearing on Monday, said later that he was pleased with the outcome of the plea agreement.

“I am happy to see justice being served,” he said.

Lembo said he was in “complete and total shock” when he found out that two longtime employees that he trusted were taking money from him.

“They were paid well,” he said. “They were rewarded handsomely. And yet they stole.”

 


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http://www.northjersey.com/news/two-ex-employees-in-haledon-dental-office-plead-guilty-in-theft-of-200-000-from-office-1.744525