Dentist broke patient’s teeth so he could swindle insurers out of millions, feds say [The Charlotte Observer]

Charlotte Observer (NC)

A Wisconsin dentist has been found guilty of purposefully breaking his patient’s teeth in order to submit fraudulent claims worth millions to insurance companies.

Scott Charmoli, a 61-year-old from Grafton, was convicted of five counts of healthcare fraud and two counts of making false statements related to healthcare matters in a jury trial, the Department of Justice announced in a March 11 release.

Charmoli’s lawyer did not immediately respond to a request for comment from McClatchy News.

The Jackson dentist spearheaded a years-long scheme to defraud several insurance agencies by alleging his patients needed crowns on their teeth, when in fact he was drilling into their teeth to partially break them and then apply the crowns, prosecutors said.

He would “aggressively sell” patients on crown procedures beginning in 2015, prosecutors said, causing “permanent disfigurement and serious bodily injury.”

He would then take X-ray images of the teeth after he drilled into them, prosecutors said, and send them to insurers as proof of the necessity of the crowns he billed the companies for.

During the scheme, which lasted from at least 2016 to 2019, he billed insurance companies over $4.2 million, and performed over 700 crown procedures yearly from 2015 to 2019, according to the news release.

According to court documents, Charmoli himself pocketed hundreds of thousands of dollars from these claims. The amounts not covered by insurance were often paid out-of-pocket by patients.

He is scheduled to be sentenced on June 17, and faces up to ten years in prison for each healthcare fraud conviction and five years for each false statement conviction, the release said.

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