The Connecticut Attorney General has reached a settlement with the owner of six dental management and consulting firms accused of Medicaid fraud.
One of 28 individuals accused of participating in a two-year $24 million false claims scheme, Rhode Island resident Gary Anusavice, a trained dentist and the firms' owner, settled with Connecticut for $9 million and was separately indicted on and pleaded guilty to federal charges for his involvement in the same fraud.
"This settlement provides restitution to the Connecticut Medical Assistance Program and permanently bars Mr. Anusavice from participating in that program," Attorney General George Jepsen said. "In addition, he has agreed to cooperate with the state's ongoing investigation and litigation of this matter, as well as any other matter related to the alleged scheme."
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The roots of the apparent fraud scheme go back to 1997, when Anusavice, as a dentist, was convicted in Massachusetts on felony charges of submitting false healthcare claims and, as part of his sentence, was permanently barred from participating in Medicare, Medicaid or any state health programs.
Anusavice went onto violate the terms of that exclusion, Connecticut's complaint said, by using several corporations to set up dental practices in Connecticut that were then operated by practicing dentists participating in Medicaid.
Anusavice was "actively managing" the practices, the complaint said -- reviewing patient and billing data, suggesting dental procedures and in general overseeing the businesses. The practices did not disclose Anusavice's ownership to the state, as federal and state laws required, as he went to "implement a billing system that resulted in the state Medicaid program being double-billed for certain dental services, or billed for services that were not rendered," the Attorney General Jepsen said.
The Department of Social Services noticed the billing patterns, and in a subsequent civil suit, the Connecticut attorney general's office accused Anusavice of violating the Connecticut False Claims Act and the Connecticut Unfair Trade Practices Act, under which he and his companies are now paying the state $9.9 million in damages and restitution.
Anusavice is also forfeiting his property in Rhode Island as part of the deal, including a $63,000 2008 Mercedes Benz, a $38,000 33-foot yacht and $91,700 in cash the FBI found in his Rhode Island home last May -- the same house that burned in a fire last November that Rhode Island officials categorized as arson (although no one has been charged).
As part of the plea deal, Anusavice is also barred from participating in any healthcare-related business with the Connecticut government or doing any other business with the state for at least 10 years -- which is roughly the amount of time the 59-year-old could spend in prison after he's sentenced on the federal charges in August.
Dentist photo from Shutterstock.com.