Success Stories - Archives

December 2003

DENTIST CONVICTED OF MEDICAID FRAUD

State of Maryland's Attorney General J. Joseph Curran, Jr. announced today that Scott Steckler, DDS, a dentist practicing in Prince George's and St. Mary's Counties, pled guilty in the Circuit Court for Baltimore City to Medicaid fraud. The Honorable Roger W. Brown sentenced Steckler to three years in jail, suspended, and placed Steckler on three years probation. Brown ordered Steckler to pay restitution in the amount of $56,658.30, one-half of which was paid at the hearing and the remaining $28,329.15 is to be paid within 180 days of sentencing. Brown also ordered Steckler to perform 100 hours of community service as a dentist.

Steckler, 35, of Thistlebridge Way in Rockville, is a Maryland dentist with two practices in the state: California Family Dentistry, located at 22684 Three Notch Road in Lexington Park and Fatemi & Steckler Family and Cosmetic Dentistry, at 7611 South Osborne Road in Upper Marlboro. Steckler was convicted of defrauding Medicaid over a 2 and 1/2 year period, from April 1998 to September 2000.

During that time, Steckler and his dental practices routinely billed Medicaid for services that were not performed. Steckler billed for hundreds of x-rays that were not taken and billed for complex dental procedures when simple ones were in fact performed. Each invoice sent to the Medicaid system contains a certification that ''the procedures as indicated by date have been completed.'' Steckler signed these forms despite knowing that certain procedures had not in fact been performed at all. Steckler took financial responsibility for one-half of the money taken by fraud by his two practices and was ordered to pay a penalty of almost $25,000 on top of the actual loss. His dental practice partner, Dr. Ali Fatemi, was also charged with Medicaid fraud related to the same time period. Dr. Fatemi has a court date of February 24, 2004.

This case was prosecuted by the Medicaid Fraud Control Unit of Maryland Attorney General's Office and was referred by the Special Investigations Unit of United Concordia.

May 2003

Baltimore, Maryland: Thomas M. DiBiagio, United States Attorney for the District of Maryland, announced today that Chui Lun Lui, also known as Alan Lui, age 54, a former military dentist with offices at 12908 New Hampshire Road, Silver Spring, Maryland, agreed to pay $100,000 to the government in settlement of a case arising under the False Claims Act. Dr. Lui was also sentenced today by U.S. District Judge Peter J. Messitte in United States v. Chui Lun Lui, PJM 01-CR 0559, a federal criminal case arising from the same investigation, to 2 years probation, 120 hours community service and ordered to pay $18,553.60 in restitution. The amount Dr. Lui is required to pay in restitution in the criminal case is offset against the $100,000 in damages and civil penalties that he must pay under the False Claims Act.

The case arose as the result of an investigation by United Concordia Companies, Inc. and TRICARE Management Activity. TRICARE is a federally funded, statutory health benefits entitlement program for active duty members of the uniformed services, their family members, retirees, and survivors. TRICARE is administered by the United States Department of Defense. United Concordia was the dental plan contractor for TRICARE's health care benefits plan.

The government alleged that from May 1997 through August 1999, Dr. Lui submitted or caused to be submitted false claims for reimbursement to TRICARE for dental work allegedly performed on children who were family members of uniformed services personnel. The government alleged that Dr. Lui submitted false claims for medically unnecessary periodontal scaling and root planing performed on children ranging in age from two years old to 15 years. Periodontal scaling and root planing is a procedure used to treat periodontitis, a gum disease which causes gum tissue at the base of the tooth to separate from the root of the tooth. Periodontal scaling and root planing is a painful and lengthy procedure, often performed under local anesthesia, and is not meant to be prophylactic in nature.

The government further alleged that from May, 1997 through August, 1999 Dr. Lui submitted claims for periodontal scaling and root planing on 21 children in the absence of x-rays and other documentation showing any medical necessity for the treatment. Dr. Lui submitted approximately $8,250 in false claims to TRICARE for periodontal scaling and root planing performed on children during this period. The damages and penalties in this case reached $100,000 because the False Claims Act provides for treble damages and up to $11,000 per count for each submission of a false claim to a government-funded health plan for reimbursement for medical or dental services provided.

The investigation was conducted by the United States Department of Defense, the United States Attorney's Office in the District of Maryland and the Special Investigations Unit from United Concordia Companies, Inc. Assistant United States Attorney Odessa P. Jackson handled the criminal investigation and Assistant United States Attorney Virginia B. Evans handled the civil case.

July 2002

The Office of the Inspector General (OIG) of the Department of Defense (DoD) announced today that on July 17, 2002, Ralph J. Sharow, a Freehold, NJ, dentist, was sentenced in U.S. District Court, Newark, NJ, to 27 months in prison and 3 years probation on each count, to run concurrently; restitution of $264,363.90; and a special assessment fee of $200. The sentence was handed down by U.S. District Court Judge William H. Walls. This sentence is the result of a guilty plea that Sharow entered on January 16, 2002. Sharow pled guilty to a two-count criminal information charging him with one count of health care fraud and one count of income tax evasion.

An investigation revealed that from as early as 1994, Sharow, who operates a dental practice at 1 Stonehurst Boulevard, Freehold, NJ, defrauded the DoD insurance program known as TRICARE and private dental insurance programs out of approximately $200,000 by billing for services that he did not provide. The TRICARE loss alone totaled approximately $20,000. Furthermore, for the years of 1995, 1996, and 1997 combined, Sharow evaded $392,998 in federal income tax by submitting false tax returns to the Internal Revenue Service (IRS). In the 3 years combined, Sharow underreported his income by $915,648.