Mass. dentist gets jail for role in Medicaid fraud

A dentist in Massachusetts was sentenced on August 10 to 18 months in prison and ordered to pay more than $1.1 million in restitution for his role in a Medicaid fraud scheme, according to the U.S. Department of Justice.

Dr. Scott Cale, 68, who pleaded guilty in April to one count of conspiring to commit healthcare fraud and one count of healthcare fraud, was also sentenced to one year of supervised release, according to a press release dated August 10 from the U.S. Attorney’s Office for the District of Massachusetts. In January 2020, Cale; Dr. Anthony DiStefano III, a fellow dentist in Massachusetts; and Robin Cronin, a dental office manager, were indicted.

Due to concerns about the quality of care he delivered to patients, DiStefano was barred from participating in the MassHealth insurance program. To circumvent his exclusion from the program, DiStefano allegedly recruited Cale to join his practice.

From 2014 to 2018, dental services that DiStefano personally delivered were purportedly billed to MassHealth using Cale’s provider identification credentials. Some of the reimbursements Cale received he reportedly paid to DiStefano.

As a result of this scheme, multiple MassHealth patients were harmed and received dangerously poor care from DiStefano. Nevertheless, charges against DiStefano were dismissed. In September 2021, Cronin, who pleaded guilty to her role in the conspiracy, is set to be sentenced in August.