White Coat

16250976 - doctor in white apron standing with stethoscope

White coats worn by healthcare professionals signify that they have the medical knowledge and authority to provide service to their patients. Whether a doctor, dentist, therapist, or lab worker, that white coat is a reminder that they are supposed to conduct their lives and practice their skills with honor and in an honest manner. A Charleston, West Virginia man who overcame extensive obstacles to become a dentist, built a profitable business at the expense of his victims and his state’s Medicaid program. One of the ways he committed Medicaid fraud was by illegally prescribing opioids to his patients even though they did not need them.

It seems like there is not a day that goes by where there is some mention of the opioid crisis in America. According to the National Institute on Drug Abuse, the sharpest increase in overdose deaths occurred among those related to fentanyl and synthetic opioids. (There were over 20,000 overdose deaths in 2016.) From 2002 to 2015, the number of deaths involving prescription opioid pain relievers topped out at about 18,000. (To say opioid abuse is an epidemic is an understatement.)

The former Charleston dentist used his white coat to prescribe unneeded opioids to patients he did not even evaluate. (Two of his patients overdosed, but fortunately, they survived. Lucky for him, or he would have been facing charges related to their deaths.) Then, he fraudulently billed West Virginia’s Medicaid program and West Virginia Medicaid Managed Care Organizations for $1.4 million over a five-year period. (This is despite the fact he only performed enough services to legitimately receive $656,130 from Medicaid.) In total he defrauded Medicaid out of $735,077.

The former West Virginia dentist has four college-aged children who are currently pursuing medical degrees. Three of his kids want to be doctors and a fourth intends to become a veterinarian. (I’m guessing some of those stolen Medicaid funds went to pay for his kids’ college funds.)

The judge in this fraudster’s case stated that the court had evidence of the dentist committing at least 7,836 acts of fraud. (If the former dentist had been charged for each individual action, he would have been in prison for centuries.) In addition to illegally prescribing opioids, he also double-billed Medicaid and “upcoded” his bills. (He claimed that he completed more complex procedures than he actually did so he could get more money from the government health care program.) There were also bogus charges for unnecessary tooth extractions and multiple dentist appointments for simple procedures that did not need additional visits. (Each time a patient walked in the door, the dentist office got to bill Medicaid for the unnecessary visit.)

The 58-year-old West Virginian was sentenced to five years in prison for Medicaid fraud. Following the completion of his sentence, he will serve three years of supervised release. The former dentist avoided fees and restitution because he previously paid $2.2 million to the agencies he defrauded. He has also lost his license to practice dentistry.

It’s important to note that today’s fraudster fled Beirut at age 16 during the Lebanese war to come to America. He was chasing the American dream and became a dentist because he wanted to help other people. The former dentist confessed to Drug Enforcement Administration agents that he prescribed his patients the low-dose opioids when he had not treated them and knew they were addicted. He said he did it because it would enable him to make the money he thought he was entitled to make. (The blinding truth shows that this criminal’s white jacket was just a cover up for a very greedy man.)

 Today’s “Fraud of the Day” is based on an article entitled, Ex-Charleston dentist sentenced to federal prison for Medicaid fraud,” published by Charleston Gazette-Mail on December 7, 2017.

U.S. District Judge Joseph Goodwin said a former Charleston dentist’s personal wealth was accumulated at the cost of keeping some of his patients addicted to opioids and defrauding Medicaid as he sentenced him to prison Thursday morning.

In front of more than 20 people supporting Antoine E. Skaff, Goodwin sentenced Skaff to five years in federal prison for healthcare fraud.

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Larry Benson, Senior Director of Strategic Alliances, LexisNexis Risk Solutions - Government

Larry Benson is responsible for developing strategic partnerships and solutions for the government vertical. His expertise focuses on how government programs are defrauded by criminal groups, and the approaches necessary to prevent them from succeeding.

Mr. Benson has 30 years of experience in sales and business development. Before joining LexisNexis® Risk Solutions, he spent 12 years founding and managing two software technology startups. During the 1990s he spent 10 years as a Regional Director helping to grow a New England-based technology company from 300 employees to 7,000. He started his career with Martin Marietta Aerospace working on laser guided weapons and day/night vision systems.

A sought-after speaker and accomplished writer, Mr. Benson is the principal author of “Fraud of the Day,” a website dedicated to educating government officials about how criminals are defrauding government programs. He has co-authored WTF? Where’s the Fraud? How to Unmask and Stop Identity Fraud’s Drain on Our Government, and Data Personified, How Fraud is Changing the Meaning of Identity.

Benson holds a Bachelor of Science in Physics from Albright College, and earned two graduate degrees – a Master of Business Administration from Florida Institute of Technology, and a Master of Science in Engineering from Lehigh University.