Acting Mass. U.S. Attorney: Chelmsford Dentist Sentenced to More Than a Year in Prison for Medicaid Fraud Scheme - Insurance News | InsuranceNewsNet

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August 11, 2023 Newswires
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Acting Mass. U.S. Attorney: Chelmsford Dentist Sentenced to More Than a Year in Prison for Medicaid Fraud Scheme

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BOSTON, Massachusetts, Aug. 11 -- The Acting U.S. Attorney for the District of Massachusetts, Joshua S. Levy, issued the following news release on Aug. 10, 2023:

A Chelmsford dentist was sentenced today in federal court in Worcester for engaging in a Medicaid Fraud Scheme.

Dr. Scott Cale, 68, was sentenced by U.S. District Court Judge Margaret R. Guzman to 18 months in prison and one year of supervised release. Cale was also ordered to pay restitution of over $1.1 million. In April 2023, Cale pleaded guilty to one count of conspiring to commit health care fraud and one count of health care fraud.

Cale was indicted by a grand jury and arrested in January 2020 along with co-conspirators Dr. Anthony DiStefano III, a fellow dentist practicing in Worcester, and Robin Cronin, a Worcester Dental Office Manager. DiStefano was barred from participating in the MassHealth insurance program because of concerns regarding the quality of dental care DiStefano delivered to patients. In order to circumvent his exclusion from the MassHealth provider network, DiStefano recruited Cale to join his practice.

From 2014 to 2018, dental services that DiStefano personally delivered were billed to MassHealth using Cale's provider identification credentials. Cale then paid DiStefano a share of the money that MassHealth had paid Cale. The purpose of this arrangement was to deceive MassHealth into paying for dental services that were not reimbursable (because MassHealth had terminated DiStefano from the MassHealth program). As a result of this scheme, multiple MassHealth patients were harmed and received dangerously poor care from DiStefano.

Charges against the DiStefano were dismissed. Cronin pleaded guilty to her role in the conspiracy in September 2021. She is scheduled to be sentenced on Aug. 15, 2023.

Acting United States Attorney Joshua S. Levy; Roberto Coviello, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of the Inspector General, Office of Investigations; and Andrea Joy Campbell, Attorney General for the Commonwealth of Massachusetts made the announcement. Assistant U.S. Attorneys Evan Panich of the Narcotics & Money Laundering Unit and Chris Looney of the Health Care Fraud Unit and Special Assistant U.S. Attorney Kevin Lownds, detailed from Campbell's office, prosecuted the case. Additional attorneys and investigators in the Office of the Attorney General for the Commonwealth of Massachusetts played a significant role in conducting the investigation.

* * *

Original text here: https://www.justice.gov/usao-ma/pr/chelmsford-dentist-sentenced-more-year-prison-medicaid-fraud-scheme

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