New Jersey Attorney General Jeffrey Chiesa has indicted five dentists, an office manager, and a billing manager in a $5.5 million Medicaid fraud scheme.
The Office of the Insurance Fraud Prosecutor's 31-count state grand jury indictment charges the employees of New Jersey Mobile Dental Practice, a now-defunct practice, with conspiracy, insurance fraud, healthcare claims fraud, theft by deception, and one count of misconduct by a corporate official in addition to third-degree Medicaid fraud for their roles in the alleged scheme.
New Jersey Mobile, which had a business office in Colts Neck, comprised a group of dentists that traveled to various nursing homes, assisted living facilities, adult day care facilities, and private homes throughout New Jersey to provide onsite dental treatment.
The indicted are listed below:
- Stephen Beukas, DMD, owner of New Jersey Mobile Dental Practice
- Illuminata Davi, office manager at New Jersey Mobile
- Joyce Fuller, Medicaid billing manager at New Jersey Mobile
- Mary D. Anerousis, DDS
- John Freiler, DDS
- Matthew Girardy, DMD
- Trina Ruchelman, DMD
The indictment alleges that between January 1, 2003, and August 1, 2009, Dr. Beukas, Davi, and Fuller stole $5.55 million from Medicaid by creating the false impression that Drs. Anerousis, Freiler, Girardy, and Ruchelman, as well as other mobile dentists, were entitled to reimbursement for dental services they purportedly provided. In some instances, the defendants allegedly overbilled Medicaid for services that were provided through the mobile dental practice.
New Jersey Mobile is alleged to have systematically added a charge for behavior management on almost every Medicaid patient purportedly treated, regardless of whether the dentists actually spent the additional time with the patient that would warrant that charge.
In other instances, the dentists allegedly billed Medicaid for dental procedures that were not provided. For example, the indictment alleges that Dr. Beukas and Dr. Anerousis caused 3,714 claims to be fraudulently submitted to Medicaid for reimbursement for a dental procedure that was never provided.
The indictment also alleges that the defendants would systematically add a "trip charge" to almost every Medicaid patient in the facility, despite the fact that the dentists were only entitled to one per trip to the facility, regardless of the number of patients examined or treated. The dentists then allegedly retained the payments from Medicaid to which they were not entitled.
The investigation began when the Medicaid Fraud Control Unit uncovered New Jersey Mobile's suspicious billing for Medicaid patients.
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