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Medicaid
Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

Opening joke at an otorhinolaryngologists’ convention: “Two years ago, my doctor told me I was going deaf. I haven’t heard from him since.” Maybe an innocent joke to make a lecture more enjoyable, but a reality for the many patients of Dennis Dellaghelfa. Dellaghelfa was a licensed hearing instrument specialist and the owner of the hearing aid company, General Hearing. But instead of a practice dedicated to delivering the best hearing experience possible, Dellaghelfa dedicated himself to stealing from the U.S. taxpayer.

From approximately June 2016 to April 2022, Dellaghelfa submitted millions of dollars in fraudulent claims to Medicaid for services and hearing aid equipment that were not provided nor medically unnecessary.  Most of the time he wasn’t even in the clinic. A detail he believed Medicaid wouldn’t catch. In fact, Dellaghelfa submitted claims for services provided to patients during a period that Dellaghelfa was traveling outside the U.S. In 2019 and 2020, some of the fraudulent claims involved services that were purportedly provided by his three employees. However, those three employees did not have the required professional permit for the tasks. With all the fraudulent claims, Dellaghelfa knowingly submitted paperwork for hearing tests and services that did not occur or were not medically necessary.

Dellaghelfa paid third-party patient recruiters for each Medicaid patient they brought to General Hearing for a hearing test who would fail the test. The patient would then qualify for free hearing aids paid for by Medicaid. Didn’t matter if the patients did pass the test. Turns out Dellaghelfa flunked them anyway. On September 6, 2023, Dellaghelfa pleaded guilty to medical fraud. He was ordered to 4 years in prison and full restitution of over $6 million to the Connecticut Medicaid program.

Great job the Department of Health and Human Services.

Today’s Fraud of The Day is based on article “Hearing Aid Business Owner Gets Prison Time for Healthcare Fraud” published by The Hearing Review on September 7, 2023 

Dennis Dellaghelfa, 54, of Waterbury, Conn., was sentenced this week to 48 months of prison, followed by three years of supervised release, for healthcare fraud related to his hearing aid business.

According to court documents and statements made in court, Dellaghelfa is a licensed hearing instrument specialist and the owner of General Hearing, a Waterbury-based hearing aid dealer. Since approximately 2013, General Hearing has been a participating provider enrolled in the Connecticut Medical Assistance Program (CTMAP), Connecticut Department of Social Services-administered program that provides medical assistance to low-income persons. CTMAP’s benefit packages, referred to as “HUSKY” or “Connecticut Medicaid,” are jointly funded by the State of Connecticut and the federal government.

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