Insurance Fraud NEWS
'Bad dentist' avoids prison in Medicaid fraud scheme
April 23, 2019, Springfield, MO
Federal prosecutors say it was a symbiotic relationship.
Dental clinic owner Pamela Van Drie needed a dentist who would go along with her plan to defraud Medicaid without asking too many questions.
And dentist James Dye needed a dental office willing to hire him despite the multiple complaints brought against him for shoddy care.
The U.S. Attorney's Office for the Western District of Missouri says Dye and Van Drie teamed up to defraud the government of more than $165,000 in a scheme involving mouthpieces between 2010 and 2015.
Prosecutors say Dye would provide patients with $50 Ortho-Tain devices that look similar to football mouth guards and are designed to straighten teeth. Van Drie would then bill the devices to Medicaid as "speech aid prosthesis" for almost $700 through the Springfield-based business All About Smiles that Van Drie owned with her husband, Lorin.
This happened more than 240 times before they were caught, according to court documents.
On Tuesday, Dye went before Judge Doug Harpool for a sentencing hearing.
Federal prosecutors asked that the 69-year-old dentist be sent to prison for a year, saying his defrauding of Medicaid equated to stealing from the "poorest of the poor."
Dye's attorney John Appelquist asked for probation, saying Dye cooperated with the government and helped convict the Van Dries by testifying at their trial earlier this year.
Appelquist also pointed out that Dye did not profit from the scheme. Dye's only benefit was getting to work as a dentist at a salary that paid him about $48,000 a year.
Judge Harpool ultimately decided on a sentence of 5 years probation along with an order to pay $167,000 in restitution.
Harpool said it was "reprehensible" to steal from Medicaid, but he ultimately didn't think prison was appropriate after considering all the factors, including Dye's cooperation in the case.
During Tuesday's hearing, prosecutors brought up Dye's questionable record as a dental care provider.
Between July 2012 and June 2014, the state's Dental Board received eight separate complaints against Dye alleging substandard care, improper billing, using toxic doses of Septocaine and leaving root tips in patients' mouths when extracting teeth, according to records maintained by the state.
Harpool said Dye was not being sentenced for being a "bad dentist," but he did feel it was important to include a provision in Dye's probation that he not re-apply for his dental license for the next five years as a way to "protect the public."
Dye will also be confined to his home for the first year of his probation unless he is leaving the house for work, medical appointments or other special circumstances.
The Van Dries have not yet been sentenced for their roles in this scheme and another fraud scheme not involving Dye.
Source: Sprinfield News-Leader