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April 4, 2013

 

DiNapoli: Audit Links Six Downstate Dentists
to $2.3 Million Medicaid Fraud

Owner Sentenced to Prison after Joint Investigation
By DiNapoli and Schneiderman

New York State Comptroller Thomas P. DiNapoli released his final audit today of a fraudulent Brooklyn dental practice after a joint investigation with Attorney General Eric T. Schneiderman resulted in a one-to-three-year sentence plus nearly $700,000 in restitution from owner Lawrence J. Bruckner.

“Medicaid fraud exploits our most vulnerable citizens at taxpayer expense,” DiNapoli said. “By driving out cheaters, we can reduce burgeoning health care costs and ensure proper treatment for those in need. My office will continue to aggressively examine the proper use of Medicaid money in New York and work with Attorney General Schneiderman to investigate and prosecute abusers. State regulators must tighten controls in the Medicaid system that my office has found were exploited by dentists too many times.”

DiNapoli’s audit and investigation found that Bruckner, 63, of Plainview, N.Y., worked with five affiliated dentists who took in nearly $7 million in Medicaid payments from 2007 to 2011, at least $2.3 million of which was likely fraudulent. The practice was based largely on the illegal recruiting of Medicaid recipients and billings for services never rendered, auditors found.

The offices, at 1155 Broadway and 1218 Remsen Ave. in Brooklyn, consisted of unsanitary examination rooms to which homeless and indigent patients were vanned or recruited off the street and paid $25 to $30 in kickbacks for “treatment” that sometimes constituted apparent malpractice, according to the audit.

All six dentists, including Bruckner, shared improper claim payments from high-volume billings for services that would be impossible to properly perform. On a single day in 2010, for example, auditors found dentist Robert Thaler was paid for 119 procedures that would have taken at least 38 hours to perform properly.

The joint investigation continues into the billings of Thaler, Allan Lebovitz, David Bruckner and Arthur Bruckner. Joseph Bruckner – Lawrence Bruckner’s son who never practiced at his father’s offices – signed blank Medicaid claim forms, drawing $471,703 in false payments for his father. His father paid full restitution on those claims. Joseph Bruckner was not charged.

In addition, unsanitary conditions at both dental offices included dirty floors, dusty equipment, and a used glove and exposed hypodermic needle on the floor. In New York State, such neglect is considered professional misconduct.

Examples of shoddy work uncovered by auditors and investigators included:

  • Thirty-three fillings that were not medically necessary or performed on teeth that were falling out or needed to be extracted;
  • Thirteen fillings not visible on x-rays taken after the procedure and were likely not done; and
  • Four fillings on teeth that the recipient did not have.

DiNapoli recommended that the Department of Health and the Office of the Medicaid Inspector General:

  • Determine whether the dentists should be removed from participation in the Medicaid program and if they should be referred to the State Education Department’s Office of the Professions to review their dental licenses;
  • Determine if additional recoveries of claims payments should be made.

Prior DiNapoli audits have found dentists exploiting Medicaid:
Department of Health: Inappropriate Medicaid Billings for Dental Restorations (2007-S-71)
Department of Health: Inappropriate Medicaid Billings for Dental Services (2007-S-3)
Department of Health: Inappropriate Medicaid Billings for Dental Services (2008-S-67)

For a copy of the latest report visit: http://www.osc.state.ny.us/audits/allaudits/093013/10s64.pdf

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