Specifically, between 2015 and 2019, he performed more than 700 crowns, even doing more than 1,000 such procedures in two of those years. In fact, between 2016 and 2019 alone, he billed more than 4.2 million dollars for crowns.
The District Court for the Eastern District of Wisconsin (USA) found dentist Scott Charmoli guilty of having damaged the teeth of thousands of patients to charge for fixing them, according to a statement published on the website of the US Department of Justice.
According to the ruling issued by US Attorney Richard Frohling on March 10, the 61-year-old has been convicted of five counts of health care fraud and two counts of false statements related to health care issues.
The text indicates that for years Charmoli defrauded dental insurance companies with the aim of paying for unnecessary coronary procedures, detailing that it began in 2015, when he began to “aggressively” sell crowns to his patients.
What was your ‘modus operandi’?
Once convinced, he would intentionally break their teeth with a dental drill and take photographs and X-rays of the damage inflicted. Later, she sent those images to insurers as support for their requests for payment of medical interventions.
Insurance companies assumed that the damage represented the pre-operative condition of the teeth and therefore paid what he requested. Many of the affected patients also paid significant copays for these coronary procedures.
The evidence collected shows that the licensed dentist placed far more crowns than most Wisconsin dentists, ranking in the 95th percentile or higher for crowns performed each year from 2016 to 2019.
Specifically, between 2015 and 2019, he performed more than 700 crowns, even doing more than 1,000 such procedures in two of those years. In fact, between 2016 and 2019 alone, he billed more than 4.2 million dollars for crowns.
On the other hand, the evidence also shows that Charmoli made false statements to dental insurers when some of them refused to pay initial claims for coverage of coronary procedures.
The sentence against the dentist is scheduled for June 17. He faces a maximum sentence of ten years in prison for each health care fraud conviction and a maximum sentence of five years in prison for each false statement.
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