Attorney General Tong Announces Joint State/Federal Settlement With Bristol Oral Surgeon Over Bills For Nonpermitted Dental Services
(Hartford, CT) – Attorney General William Tong today announced a $149,000 joint state/federal settlement with Bristol oral surgeon Ean James regarding claims he submitted to the state’s Medicaid program for administering anesthesia and conscious sedation services to his patients after his permit had expired.
Connecticut law requires dentists to hold an active permit from the Department of Public Health (DPH) to administer moderate or deep sedation or general anesthesia during dental procedures. The permit must be renewed annually. On January 31, 2018 the DPH sent James a renewal notice notifying him that his dental anesthesia/conscious sedation permit would expire on April 30, 2018. Under Connecticut law, a dentist has a 90-day grace period after the expiration date to renew the permit before it becomes void. Thus, James had until July 31, 2018 to renew his permit. James did not apply to the DPH to reinstate his permit until April 30, 2019.
During the time when his permit had lapsed, James continued to administer general anesthesia and sedation to his Medicaid patients, and continued to submit claims to the Connecticut Medicaid Program for these services.
“Dr. James was given ample notice and time to comply to renew his permit, yet he continued to administer general anesthesia after his permit lapsed. State permitting processes are in place to ensure patient safety and it is important that all healthcare providers comply,” said Attorney General Tong.
“It is critical that all dental and medical providers adhere to the professional standards required by the State of Connecticut. Dr. James is now in compliance with his permit requirements, and we join Attorney General Tong in thanking state and federal investigators and regulators who were instrumental in addressing this case,” said Dr. Deidre S. Gifford, Commissioner of the Department of Social Services (administering agency for Medicaid) and Acting Commissioner of the Department of Public Health.
The joint state/federal investigation was conducted by the Office of the Attorney General; the United States Attorney's Office, District of Connecticut; and the United States Department of Health and Human Services, Office of the Inspector General, Office of Investigations, following a fraud referral from the DSS Office of Quality Assurance's Special Investigations Unit. The Connecticut Department of Public Health also provided valuable support throughout the investigation. Attorney General Tong thanked all involved in the joint investigation for the considerable assistance they provided.
Anyone with knowledge of suspected fraud or abuse in the public healthcare system is asked to contact the Attorney General’s Antitrust and Government Program Fraud Department at 860-808-5040 or by email at email@example.com; the Medicaid Fraud Control Unit at 860-258-5986 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 to email@example.com
Forensic Fraud Examiner Kevin Jeffko and Michael E. Cole, Chief of the Antitrust and Government Program Fraud Department, assisted the Attorney General with this matter.