Tag Archives: Harold H. Shaw

National Dental Clinic Chain to Pay $1.3 Million to Resolve Allegations of Overbilling Medicaid

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Tuesday, September 5, 2017

BOSTON – The U.S. Attorney’s Office and the Massachusetts Attorney General’s Office announced today that Dental Dreams, LLC, a national dental chain with locations in Massachusetts, has agreed to pay $1.375 million to resolve allegations that it improperly billed the Massachusetts Medicaid program (MassHealth) for unnecessary and unjustifiable dental procedures.

“Dental Dreams enriched itself at taxpayer expense by improperly billing Medicaid,” said Acting U.S. Attorney William D. Weinreb. “We will continue to work with our law enforcement partners to ensure that federal and state health care dollars are spent properly.”

“This dental chain’s extensive improper billing violated state regulations and cost our state’s Medicaid program more than a million dollars,” said Massachusetts Attorney General Maura Healey. “As a result of this joint investigation, today’s settlement provides restitution to MassHealth and ensures that these funds are properly used to benefit its members.”

“Medicaid is designed to provide health care services to some of the most vulnerable members of our society and it’s our agency’s mission to ensure government health funds are spent properly,” said Special Agent in Charge Phillip M. Coyne of the U.S. Department of Health and Human Services Office of Inspector General. “Working with our Federal and State partners, we will continue to hold accountable any medical professional who, just to enrich themselves, bills Medicaid for more intensive and expensive services than those actually provided.”

“The company took advantage of a vulnerable patient population when it submitted claims to MassHealth for medically unnecessary and unreasonable dental procedures,” said Harold H. Shaw, Special Agent in Charge of the Federal Bureau of Investigation, Boston Field Division. “Today’s settlement underscores the FBI’s commitment to investigate health care providers who overbill federal and private health insurance programs to maximize profits. We urge anyone with information regarding overbilling practices to contact us.”

The settlement resolves allegations that Dental Dreams overbilled the Massachusetts Medicaid program for surgical extractions of teeth and for a specific kind of oral examination.

The settlement resolves a lawsuit filed by a former employee under the whistleblower provisions of the False Claims Act, which permits private parties to sue on behalf of the government for false claims for government funds and to receive a share of any recovery.

Acting U.S. Attorney Weinreb, Massachusetts Attorney General Healey, HHS-OIG SAC Coyne and FBI SAC Shaw made the announcement today. The case was handled by Assistant U.S. Attorneys Michelle Leung, Sonya Rao, and Kriss Basil of Weinreb’s Civil Division and Assistant Attorney General Stephany Collamore of Healey’s Medicaid Fraud Division.

Wholesale Jewelry Distributor Charged in Multi-Million Dollar Fraud Scheme

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Thursday, July 20, 2017

PROVIDENCE – Gerald Kent, 51, of Groton, CT, owner and operator of Kent Jewelry in Johnston, RI., made an initial appearance in U.S. District Court in Providence today and was ordered detained in federal custody, charged by way of a criminal complaint with wire fraud and aggravated identity theft.

It is alleged in court documents that Kent, through his company, which primarily sells jewelry on the internet using websites such as Groupon.com and Zulily.com, orchestrated a long running, multi-million dollar fraud scheme that defrauded a debtor finance company of more than $3.6 million dollars.

The charges are announced by Acting United States Attorney Stephen G. Dambruch; Brian Deck, Resident Agent in Charge of the Providence Office of the U.S. Secret Service; and Harold H. Shaw, Special Agent in Charge of the Federal Bureau of Investigation Boston Division.

According to an affidavit in support of the criminal complaint, it is alleged that Kent submitted fraudulent invoices to a factoring (debtor finance) company based in Chicago, Ill., mostly from Groupon and Zulily, which resulted in payments to Kent of nearly $5 million dollars.

According to the affidavit, it is alleged that to execute the fraud scheme, Kent created hundreds of fraudulent invoices which were submitted to the factoring company for which he received payment; created and used a fraudulent clone of Groupon, Inc.’s website; enlisted coconspirators to pose as Groupon employees; and opened bank accounts in the names of Groupon and Zulily, Inc., in order to deceive the debtor finance company into believing it was receiving payments from these companies.

Factoring is a financial transaction and a type of debtor finance in which a business sells its accounts receivable (i.e., invoices) to a third party (called a factor) at a discount.  Factoring companies work with businesses to provide working capital in order to grow their businesses without having to wait for outstanding accounts receivables to be paid.

Kent, who was arrested on Wednesday evening at Foxwoods, appeared today before U.S. District Court Magistrate Judge Patricia A. Sullivan and was ordered detained pending a detention hearing on July 26, 2017.

A criminal complaint is merely an allegation and is not evidence of guilt. A defendant is entitled to a fair trial in which it will be the government’s burden to prove guilt beyond a reasonable doubt.

The case is being prosecuted by Assistant U.S. Attorneys Lee H. Vilker and John P. McAdams.

The matter was investigated by agents from the U.S. Secret Service and the FBI.