AG, DSS: State Reaches Settlement with Stamford-based Dentist Resolving False Claims Act Lawsuit
released on June 6, 2017
found in newsletter: June & July 2017
A Stamford-based dentist will be excluded from participation in the state’s Medicaid program for 10 years and will agree not to renew his expired dental license as part of a settlement resolving allegations that he engaged in a long-running and substantial scheme to submit false claims for dental services provided to residents of long-term care facilities in the state, Attorney General George Jepsen and state Department of Social Services (DSS) Commissioner Roderick L. Bremby announced today.
Georgy Betser and his wife, Irina Betser, and their companies – Advanced Dental Office and Laboratory, G. Betser, DDS, LLC; Dental Laboratory Advanced Management and Billing, LLC; and Mobile Management & Billing of USA, LLC. – have agreed to forfeit $755,956.30 in payments suspended by the DSS in order to resolve the state False Claims Act violations alleged against them. Dr. Betser has also agreed that he will not seek renewal of his now-expired Connecticut dental license.
Additionally, the defendants have entered into a suspension agreement with DSS in which they have agreed to be excluded from participation in the Connecticut Medical Assistance Program (CMAP) – which includes the state’s Medicaid program and is administered by DSS – for 10 years.
“Medicaid providers who choose to participate in the CMAP have a lawful obligation to ensure that they are in compliance with all applicable federal and state laws and regulations and are truthful when they submit claims for payment for services to the Medicaid program,” Attorney General Jepsen said. “This provider preyed upon the most vulnerable of our Medicaid population – our seniors who reside in nursing homes. We will continue to work hard to hold accountable those who seek to defraud our taxpayer-funded healthcare programs.”
“While this repugnant situation does not represent the Medicaid dental program and providers as a whole, it clearly demonstrates the need for strong anti-fraud measures to protect patients and taxpayers from the outliers who betray their profession,” Commissioner Bremby said. “I join Attorney General Jepsen in commending investigators and attorneys at DSS and the AG’s Office, as well as Chief State’s Attorney Kevin Kane and our partners who combat Medicaid fraud at the Division of Criminal Justice.”
The Office of the Attorney General commenced an investigation after referral from the DSS Office of Quality Assurance in February 2013. The investigation was conducted in coordination with the state Division of Criminal Justice’s Medicaid Fraud Control Unit. The Attorney General filed a civil lawsuit against the defendants alleging violations of the state False Claims Act in June 2014.
The Attorney General’s complaint alleged that from October 2009 to June 2014, the defendants purportedly provided services to dental patients enrolled in the CMAP. The patients were typically residents at long-term care facilities, and bills submitted by the defendants specified that the dental services were performed at the various facilities. The complaint further alleged that the defendants billed CMAP for dental services, including cavity fillings, that were never provided and for dentures that were improperly made and packaged, rendering them unusable.
Attorney General Jepsen thanked Chief State’s Attorney Kevin Kane, the state Division of Criminal Justice’s Medicaid Fraud Control Unit and the DSS Office of Quality Assurance for their continued partnership in investigating Medicaid fraud allegations.
Today’s action is part of a larger effort by the State of Connecticut’s Interagency Fraud Task Force, which was created in July 2013 to wage a coordinated and proactive effort to investigate and prosecute healthcare fraud directed at state healthcare and human service programs. The task force includes a number of Connecticut agencies and works with federal counterparts in the U. S. Attorney’s Office and the U.S. Health and Human Services, Office of Inspector General – Office of Investigations. For more information, please visit www.fightfraud.ct.gov.
Anyone with knowledge of suspected fraud or abuse in the public healthcare system is asked to contact the Attorney General’s Antitrust and Government Program Fraud Department at 860-808-5040 or by email at email@example.com; the Medicaid Fraud Control Unit in the Office of the Chief State’s Attorney at 860-258-5986 or by email at firstname.lastname@example.org; or the Department of Social Services fraud reporting hotline at 1-800-842-2155, online at www.ct.gov/dss/reportingfraud, or by email to email@example.com.
Forensic Fraud Examiner Larry Marini, Legal Investigator Thomas Martin and Assistant Attorney General Michael Cole, chief of the Antitrust and Government Program Fraud Department, assisted the Attorney General with this matter.
Please click here to view the settlement document.
Original Press Release