A.G. Schneiderman Obtains Guilty Plea From Rochester Dentist Who Defrauded Medicaid, Recovering $480k In Fraudulent Billings
Dentist Billed For Claims Outside The Scope Of The Medicaid Program, Will Return All Funds Owed To State
ROCHESTER – Attorney General Eric T. Schneiderman today announced a criminal disposition and civil settlement with Dr. Samir Khalil, a Rochester dentist who fraudulently billed Medicaid for services provided to his patients. Khalil previously pleaded guilty to Grand Larceny in the 4th Degree, a class E felony. Today, Khalil completed the last of his payments back to New York State and was sentenced to full restitution and community service on his felony conviction.
“A health services provider who knowingly bills for claims outside the scope of the Medicaid programis jeopardizing access to critical and cost-effective health care servicesfor millions of New Yorkers,” Attorney General Schneiderman said. “My office will hold any medical professional who steals from Medicaid accountable by demanding that he pay back all ill-gotten gains and face criminal charges.”
According to the felony complaint, from on or about January 1, 2007, to January 18, 2011, Khalil was employed as a dentist at his corporation, Parkwood Dental Care, P.C., located at 1655 Elmwood Avenuein Rochester. During that time, Khalil and his corporation improperly received more than $480,000 from Medicaid for, among other things: services and/or procedures performed by a dentist excluded from the Medicaid program or by dentists who were not Medicaid providers; billing for immediate dentures, which are not allowed under Medicaid rules and regulations; billing for dentures and other dentistry items that were never delivered to patients, and billing for surgical extractions of teeth when only simple extractions were performed.
In addition, during the aforementioned four-year period, Khalil, with intent to deprive and defraud the State, “upcoded” and billed theMedicaid program for various claims and services for fillings/restorations on the teeth of numerous Medicaid recipients, resulting in more than$3,000 in false billings.
The investigation was conducted by the following members of the Medicaid Fraud Control Unit, Rochester Office: Regional Director
and Chief of Criminal Investigations Upstate Catherine Wagner, Special Investigator Arthur Vasile, and Associate Special Auditor/Investigator Jamie Russell-Thomas, under the supervision of Supervising Investigator William Falk and Deputy Chief Thaddeus Fisher.