Dentists in Worcester, Chelmsford along with office manager indicted in Medicaid fraud scheme

A federal grand jury in Boston indicted a Worcester dentist, a Chelmsford dentist and a Worcester office manager for their alleged participation in a scheme to defraud the Massachusetts Medicaid program, commonly known as MassHealth, according to the U.S. Attorney’s Office.

Dr. Anthony DiStefano III, 70, of Worcester, was indicted on one count of conspiracy to commit health care fraud, one count of health care fraud, two counts of aggravated identity theft and one count of tax evasion.

Dr. Scott Cale, 65, of Chelmsford, and Robin Cronin, 58, of Worcester, were each indicted on one count of conspiracy to commit health care fraud and one count of health care fraud. The defendants were arrested Thursday morning and will appear in federal court in Boston, authorities said.

According to federal records, MassHealth excluded DiStefano in 2005 from participation in the MassHealth program.

“DiStefano twice sought readmission into MassHealth’s provider network but was denied both times in light of significant concerns regarding the quality of dental care he delivered to patients,” the U.S. Attorney’s Office said. “In order to circumvent his exclusion, DiStefano recruited another dentist, Cale, to join his practice.”

Authorities allege that from 2014 to 2018, dental services that DiStefano personally delivered were billed to MassHealth using Cale’s provider identification credentials.

Cale, in turn, provided DiStefano a share of the money that MassHealth paid out.

“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,” the U.S. Attorney’s Office said.

Cronin, who worked as DiStefano’s office manager, was aware of the arrangement and personally billed MassHealth for services that were not reimbursable, knowing that the claims were false, according to federal records.

The federal indictment alleges DiStefano owed “substantial tax liabilities” to the Internal Revenue Service for the years 2011 to 2014.

“The IRS notified DiStefano of his outstanding tax liability and DiStefano evaded paying his outstanding liability by, for example, ceasing the use of bank accounts and operating his business in cash; cashing Social Security checks and checks from dental insurance companies at check cashing institutions, thus avoiding IRS levies on his bank accounts; and using the aforementioned Medicaid fraud scheme to conceal his income,” the U.S. Attorney’s Office said.

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