6 dentists guilty of Medicaid nursing home fraud

Aug 24, 2010

Six New Jersey dentists have pleaded guilty in a $1.4 million Medicaid fraud case at nursing homes, the state attorney general announced.

Larry Berman, D.D.S., of Edison, a dentist employed by New Jersey Mobile Dentist of Colts Neck, NJ, pleaded guilty to third-degree conspiracy to commit Medicaid fraud, according to a statement by Attorney General Paula Dow's office.

The accusations were filed by the Office of the Insurance Fraud Prosecutor's Medicaid Fraud Control Unit, which investigates and prosecutes both civil and criminal Medicaid fraud related cases.

Dr. Berman admitted that between January 1, 2006, and March 10, 2009, as a Medicaid provider, he willfully received medical assistance payments to which he was not entitled. The payments related to fraudulent bills submitted to Medicaid for dental services for beneficiaries at various nursing homes and assisted living facilities that he did not provide or that were not medically necessary, the statement said.

The investigation revealed that as a result of the alleged fraudulent billing, Medicaid paid New Jersey Mobile Dentist, which had used Dr. Berman's Medicaid provider number, more than $280,000 to which it was not entitled. New Jersey Mobile Dentist contracts with individual dentists to provide Amobile@ dental services in such facilities throughout New Jersey.

Under the terms of the plea agreement, New Jersey will recommend that Dr. Berman be sentenced to up to 364 days in county jail as a condition of a term of probation. He must pay the state a total of $169,164, including $84,582 in restitution for amounts he received from New Jersey Mobile Dentist in connection with the fraudulent billing and an equal civil penalty of $84,582.

Five other dentists associated with New Jersey Mobile Dentist have previously pleaded guilty in this investigation:

Joshua Prensky, D.D.S., of Fair Lawn
Christopher Lillo, D.M.D., of Toms River
Anna Padva-German, D.D.S., of Secaucus
Marc Wertheim, D.M.D., of Moonachie
Subina Anand, D.M.D., of Plainsboro

Last year, Dr. Wertheim, pleaded guilty to third-degree Medicaid fraud. He admitted that between January 1, 2003, and March 10, 2009, as a Medicaid provider, he willfully received medical assistance payments to which he was not entitled. The investigation revealed that as a result of the allegedly fraudulent billing, Medicaid paid New Jersey Mobile Dentist, which had used Dr. Wertheim's Medicaid provider number, more than $280,000 to which it was not entitled. Wertheim is awaiting sentencing.

Under the terms of the plea agreement, the state will recommend that Dr. Wertheim be sentenced to 364 days in county jail as a condition of a term of probation. He must pay $225,715 to the state, representing the share of the fraudulent Medicaid billings he received from New Jersey Mobile Dentist plus a civil penalty.

In January, Dr. Anand pleaded guilty to third-degree Medicaid fraud. She admitted that between January 1, 2003, and March 10, 2009, as a Medicaid provider, she willfully received medical assistance payments to which she was not entitled. The investigation revealed that as a result of the allegedly fraudulent billing, Medicaid paid New Jersey Mobile Dentist, which had used Dr. Anand's Medicaid provider number, more than $850,000 to which it was not entitled. Anand also is awaiting sentencing.

The state will also recommend that Dr. Anand be sentenced to 364 days in county jail as a condition of a term of probation under the terms of the plea agreement. She must pay $415,201 to the state, representing the share of the fraudulent Medicaid billings she received from New Jersey Mobile Dentist plus a civil penalty.

"These dentists exploited a vulnerable population, namely elderly and disabled patients," said Acting Insurance Fraud Prosecutor Riza Dagli. "Medical professionals are given a tremendous amount of trust, and we will continue to aggressively prosecute those who take advantage of that trust."