3 dentists among 9 charged with Medicaid fraud at Ind. office

2013 05 31 14 16 37 347 Money Handcuffs 200

The Indiana attorney general has filed Medicaid fraud and other criminal charges against three dentists and six others at a dental office in Anderson.

The charges allege that Anderson Dental Center owner Sally Metzner, the dentists, and four office employees inflated Medicaid claims to get larger reimbursements, according to Attorney General Greg Zoeller. In some cases, they forged documents or charged for deep sedation but didn't have the equipment to do it, he said.

The fraud exceeded $300,000, the affidavit alleges.

“These defendants defrauded Medicaid so brazenly and repeatedly in operating their practice that it cannot be attributed to mistake or paperwork errors.”
— Greg Zoeller, Indiana attorney

The following dentists have been charged with corrupt business influence (also known as racketeering), money laundering, Medicaid fraud, and theft:

  • Paul Pangallo, DDS, 73, of Indianapolis
  • Jeffrey Rich, DDS, 69, of Cicero
  • Thomas Dubois, DDS, 46, of Indianapolis

Metzner was charged with corrupt business influence, money laundering, Medicaid fraud, theft, forgery, and practicing dentistry without a license.

Four office workers were charged with corrupt business influence:

  • Jessica (Metzner) Worrell, 27, Anderson, also charged with forgery
  • Beth Flynn-Lohrey, 45, Middletown, also charged with prescription drug fraud
  • Chris Martin, 31, Anderson, also charged with prescription drug fraud
  • Barbara Brooks, 62, Anderson, also charged with forgery

A fifth employee, Deborah R. Davis, 55, Middletown, was charged with prescription drug fraud only.

The scheme included submitting Medicaid billings for services that weren't provided, exaggerating or "upcoding" treatments for larger reimbursements than allowable, submitting claims for work performed by dentists who were not authorized Medicaid providers, submitting claims for work purportedly performed by another dentist after she no longer worked at the office, and forging signatures of dentists who no longer worked at the practice on Medicaid claims.

For example, the office submitted routine claims for nitrous oxide that should have been billed to Medicaid for approximately $30. Instead, they submitted claims for more expensive "deep sedation" procedures, billed for approximately $125 each. The affidavit noted it was physically impossible to perform deep sedation procedures since the office lacked the necessary equipment.

Fraudulent billing continued even after authorities had searched the office, according to the affidavit.

"The Medicaid program funds dental care for Indiana's neediest citizens, but if providers intentionally overbill Medicaid causing tax dollars to be wrongly paid out then all Indiana taxpayers are the victims," Zoeller said in a statement. "The allegation here is that these defendants defrauded Medicaid so brazenly and repeatedly in operating their practice that it cannot be attributed to mistake or paperwork errors."

Metzner and the others have been scamming the Medicaid system since 2006, using the money for their own purposes or investing it back into the business, the affidavit stated.

In December, the State Board of Dentistry issued a cease-and-desist order against Metzner, who is not a licensed dentist and under state law isn't allowed to own a dental clinic. Indiana officials have also revoked the Medicaid provider status of Dr. Pangallo and indefinitely suspended payments for Dr. Rich, preventing them from receiving Medicaid compensation.

Metzner has agreed to plead guilty to federal criminal charges of income tax evasion for not paying taxes on more than $850,000.

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