NJ dental group charged with $1.3M Medicaid fraud

The New Jersey Office of the State Comptroller (OSC) is seeking recoveries from a dental practice that forged Medicaid reimbursement documents to conceal that its owner, who was no longer physically able to treat patients, had been replaced with a dentist who was debarred from the Medicaid program.

Anicia Cruz-Sledge assumed control of the Gentle Dental Group in East Orange in 2007 after her husband, the owner and primary dentist for the practice, suffered a medical condition that left him incapacitated and no longer able to treat patients, according to a notice filed by the OSC's office.

The investigation by OSC's Medicaid Fraud Division found that Gentle Dental submitted Medicaid reimbursement claims using the individual Medicaid provider number of her husband, Edward Sledge, DMD; signatures purporting to be from Dr. Sledge; and certification forms stating that Dr. Sledge had performed the medical services in question.

However, those services were actually provided by Carl McGloster, DDS, a dentist hired by Cruz-Sledge to treat patients at the dental practice although he was debarred from participating in the Medicaid program. According to the OSC, Cruz-Sledge admitted to OSC investigators that she signed her husband's name on the reimbursement claim forms submitted to the state even though her husband did not treat the patients. OSC investigators also determined that Cruz-Sledge continued to order new prescription pads under her husband's name long after he became incapacitated.

Dr. McGloster issued 290 prescriptions to Medicaid patients utilizing Dr. Sledge's prescription pad, including 63 prescriptions for controlled dangerous substances, the OSC claims. Dr. McGloster was not legally authorized to treat Medicaid patients or apply for Medicaid reimbursements for any such treatment.

Cruz-Sledge also admitted to performing dental assistant and hygienist services without possessing the required state licenses. Two other dentists who were not approved to provide services to Gentle Dental Medicaid patients also were hired by Cruz-Sledge and provided such services.

All Medicaid payments to Gentle Dental were suspended by OSC in March 2012. OSC is seeking from the company more than $1.3 million for improperly reimbursed claims, damages, and penalties.

The OSC also is seeking more than $510,000 from Dr. McGloster personally for improper Medicaid claims. According to the OSC, Dr. McGloster wrote a total of 427 prescriptions to Medicaid patients while excluded from the Medicaid program.

"It is particularly brazen for someone who already has been banned from the Medicaid program to try to get around that ban by impersonating a doctor who has become medically incapacitated," State Comptroller Matthew Boxer stated in a press release.

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