Massachusetts dentists, office manager indicted on suspicion of Medicaid fraud

Two dentists and a dental office manager have been arrested for allegedly defrauding MassHealth, the Massachusetts Medicaid program, according to a Jan. 16 Department of Justice news release.

Anthony DiStefano III, DDS, was indicted on conspiracy to commit healthcare fraud, healthcare fraud, tax evasion and two counts of aggravated identity theft. Scott Cale, DDS, and Robin Cronin were each charged with conspiracy to commit healthcare fraud and healthcare fraud. All three were arrested the morning of Jan. 16 and had court appearances scheduled later in the day.

In 2005, MassHealth removed Dr. DiStefano from the MassHealth program, according to the indictment. Dr. DiStefano sought readmission to the provider network but was denied.

Dr. DiStefano then added another dentist, Dr. Cale, to his practice. From 2014-18, dental services completed by Dr. DiStefano were billed to MassHealth using Dr. Cale's provider identification, the Justice Department alleged. Dr. Cale then allegedly paid Dr. DiStefano some of the money MassHealth sent him. Ms. Cronin, the office manager, knew about the arrangement and billed MassHealth for services, according to the indictment.

Dr. DiStefano also allegedly evaded paying his taxes by closing bank accounts, operating his business in cash, cashing Social Security and dental insurance checks at check-cashing institutions, and using the alleged Medicaid fraud scheme to conceal his income.

Dr. Cale and Ms. Cronin face up to 10 years in prison and a fine as high as $250,000. Dr. DiStefano faces a prison sentence of up to 19 years and a maximum fine of $1 million.

Copyright © 2023 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.

Featured Learning Opportunities

Featured Webinars

Featured Whitepapers

Featured Podcast