Mass. U.S. Attorney: Chelmsford Dentist Pleads Guilty to Medicaid Fraud Scheme

BOSTON, Massachusetts, April 15 -- The U.S. Attorney for the District of Massachusetts, Rachael S. Rollins, issued the following news release on April 14, 2023:

A Chelmsford dentist pleaded guilty yesterday to engaging in a Medicaid Fraud Scheme.

Scott Cale, 68, pleaded guilty to one count of conspiring to commit health care fraud and one count of health care fraud. U.S. District Court Judge Margaret R. Guzman scheduled sentencing for July 20, 2023. Cale was indicted by a grand jury and arrested in January 2020 along with co-conspirator Anthony DiStefano. Charges against the DiStefano were dismissed.

DiStefano was barred from participating in the MassHealth insurance program because of significant concerns concerning 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.

The charges of health care fraud and conspiracy to commit health care fraud each provide for a sentence of up to 10 years in prison, one year of supervised release and a fine of up to $250,000. Sentences are imposed by a federal district court judge based upon the U.S. Sentencing Guidelines and statutes which govern the determination of a sentence in a criminal case.

United States Attorney Rachael S. Rollins; Andrea Joy Campbell, Attorney General for the Commonwealth of Massachusetts; and Phillip Coyne, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of the Inspector General, Office of Investigations made the announcement. Assistant U.S. Attorneys Evan Panich and Chris Looney of Rollins' Healthcare Fraud Unit and Special Assistant U.S. Attorney Kevin Lownds, detailed from Campbell's office, are prosecuting the case.

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Original text here: https://www.justice.gov/usao-ma/pr/chelmsford-dentist-pleads-guilty-medicaid-fraud-scheme