AG Jepsen: State Reaches False Claims Act
Settlement with Southington Dental Provider
A Southington dentist will pay $55,000 to settle civil healthcare fraud allegations involving the filing of false and fraudulent claims for payments from Connecticut's Medicaid program, Attorney General George Jepsen said today.
The Attorney General alleged that, while enrolled as a dental provider in the Connecticut Medical Assistance Program (CMAP), Dr. Thomas DeRienzo – a licensed dentist practicing in the Plantsville section of Southington – engaged in a long-term scheme to submit claims to the state Department of Social Services (DSS) for dental services that were not provided to his CMAP patients. In particular, Dr. DeRienzo is alleged to have falsely charged DSS for resin-based composite fillings that, in fact, patients did not receive.
Dr. DeRienzo has agreed to pay $55,000 to resolve the False Claims Act allegations. In addition, he has agreed to enter into a separate agreement with the DSS to be permanently barred from participation as a dentist in the CMAP.
"My office is committed to protecting CMAP and other state healthcare programs – as well as the taxpayers who fund them – from fraud," said Attorney General Jepsen. "By bringing state False Claims Act cases such as this, we recover funds obtained through fraud and deter others from attempting similar schemes. I appreciate the continued coordination and partnership with our client agencies and our law enforcement partners to ensure that our most vulnerable citizens as well as our taxpayer interests are protected."
DSS Commissioner Roderick L. Bremby said, "While this dentist does not represent Medicaid providers as a whole, the unfortunate case demonstrates the continuing need for strong anti-fraud oversight. This individual is permanently terminated from enrollment in Connecticut’s public health coverage programs, including Medicaid and the Children’s Health Insurance Program. We are proud of our DSS investigative staff and greatly appreciate the work of our partners in the Attorney General’s Office, Chief State’s Attorney’s Office and federal Department of Health and Human Services."
Attorney General Jepsen thanked the DSS Office of Quality Assurance, the State of Connecticut Division of Criminal Justice Medicaid Fraud Control Unit and the United States Department of Health and Human Services Office of the Inspector General-Office of Investigations, for their assistance and coordination in this case.
Today's action is part of a larger effort by the State of Connecticut's Interagency Fraud Task Force, which was created in July 2013 to wage a coordinated and proactive effort to investigate and prosecute healthcare fraud directed at state healthcare and human service programs. The task force includes a number of Connecticut agencies and works with federal counterparts in the U. S. Attorney's Office and the U.S. Health and Human Services, Office of Inspector General – Office of Investigations. For more information about the Task Force, please visit www.fightfraud.ct.gov.
Anyone with knowledge of suspected fraud or abuse in the public healthcare system is asked to contact the Medicaid Fraud Control Unit in the Office of the Chief State’s Attorney at 860-258-5986 or by email at email@example.com; the Attorney General’s Antitrust and Government Program Fraud Department at 860-808-5040 or by email at firstname.lastname@example.org; or the Department of Social Services fraud reporting hotline at 1-800-842-2155, online at www.ct.gov/dss/reportingfraud or by email at email@example.com.
Assistant Attorney General Antonia Conti, Forensic Fraud Examiner Kevin Jeffko, and Assistant Attorney General Michael Cole, chief of the Antitrust and Government Program Fraud Department, assisted the Attorney General with this matter.