Attorney General Seeks Restitution For Alleged Illegal Billing by
Dentist and Dental Practice
Attorney General George Jepsen is seeking restitution from a Winsted dentist and his practice for allegedly violating the Connecticut Unfair Trade Practices Act by illegally billing the Connecticut Medical Assistance Program from April 2002 through October 2009.
The state Department of Social Services administers the Connecticut Medical Assistance Program, which includes Medicaid and other programs that pay for medical benefits for certain low-income and disabled Connecticut residents. DSS terminated the provider agreement for Douglas J. Macko, D.M.D and on Oct. 26, 2010, suspended him from the program for 10 years.
According to the complaint, Macko and his professional corporation, Douglas J. Macko, D.M.D, P.C., in Southington, had unlicensed dental assistants perform cleanings and other dental services, which may only be performed by licensed dental professionals, and then billed the state as if Macko had performed the services. Alleged illegal billings were also made for services that were never provided.
The complaint alleges that the acts, practices and course of wrongful conduct by Macko violated public policies against larceny, vendor fraud, health insurance fraud and against a medical provider violating licensing requirements.
“This action is being brought to seek restitution, civil penalties and other relief authorized by law,” Attorney General Jepsen said. “It should also send a clear message to other providers that Connecticut will not ignore fraudulent billing and other illegal practices and will vigorously pursue restoration of taxpayer dollars lost as a result.”
DSS Commissioner Roderick L. Bremby said, "While Medicaid-enrolled providers as a group are above-board and honorable, this case underscores the need for continued vigilance in removing outliers. We thank the Attorney General's Office and Department of Consumer Protection for working with DSS anti-fraud personnel to root out waste and fraud from the system."
The Attorney General brought the action at the request of state Consumer Protection Commissioner William Rubenstein and based on a referral by DSS.
Assistant Attorney General Karen Haabestad and Gregory O’Connell are handling this matter for the Attorney General with Forensic Fraud Examiners Lawrence Marini and David Boucher, and Assistant Attorney General Arnold Menchel, head of the Health Care Fraud department.