Dentist accused of pulling scam
By CANDACE RONDEAUX, Times Staff Writer
The boy emerged from the operating room with "fresh scratches on his face" and "blood covering his face, hair, arms and shirt," his mother told state investigators. He did not receive anesthesia before Burge "laid across him and pulled his teeth out while he was screaming."
None of that, state investigators allege, stopped Burge from billing Medicaid $493.23 for the boy's painful trip to the dentist in January 2001.
The case is one of dozens unearthed by state investigators who are prosecuting Medicaid fraud charges against Burge. She was arrested on June 28 and charged with billing Medicaid for 3,331 false claims between 1998 and 2002. The charges say she fraudulently claimed $163,721.
"I saw many half-conscious, bleeding patients led out the back door soon after their surgeries were completed to make room for new patients because Dr. Burge was trying to make $10,000-$12,000 a day from Medicaid," Burge's former surgical assistant, Janet Popelier, told investigators.
In all, she rang up $6.6-million for more than 57,000 Medicaid claims in a little more than four years. Said Marilyn Lashley, one of her patients: "It was like an assembly line in there."
Records and sworn statements compiled by investigators say her patients suffered.
A 14-year-old girl was mistakenly brought to Burge's surgery room instead of an older woman with the same name. Burge removed four teeth, then placed the teeth back in the girl's mouth without telling the girl or her mother, said Kimberly Matt, Burge's former surgical assistant.
Once, Burge asked her 12-year-old son to pitch in during an operation, ordering him to administer an intravenous anesthetic to a patient, according to Matt's sworn statement.
Burge would frequently pull patients' teeth out "so hard and fast, the patients' blood would spray" and "sometimes parts of the jawbone or mandible would break," Popelier told investigators.
Experts say the millions of dollars Burge billed Medicaid should have been a "red flag" for authorities.
"To have that volume of claims would seem somewhat suspicious no matter who the doctor is, just because of the low reimbursement rate for Medicaid," said Carol O' Brien, an associate director at the American Association of Maxillofacial Surgeons.
O'Brien said that Burge was a member in good standing and said the association would refrain from commenting further on her status pending the outcome of a trial.
Burge has been in trouble several times before. She was charged with filing false claims in Colorado, investigated by Florida regulators for false advertising claims and ordered to repay more than $100,000 to the federal government.
Yet Burge, a 44-year-old graduate of the Harvard School of Dental Medicine, continues to hold a Florida dental license. Her attorney says Burge will be cleared of the most recent charges.
"I'm confident that she will be vindicated of these charges," said attorney Chuck Bavol.
She had been out of dental school just a few years when she got into trouble the first time.
Burge was working as a claims processor at a Colorado HMO in the late 1980s when she was accused of filing false medical claims. In 1989, she pleaded guilty to felony theft charges and computer crime after admitting to prosecutors that she filed $104,000 in false medical claims.
She was sentenced to 500 hours of community service, and ordered to repay the full amount. The charges were later lowered to misdemeanors in 1999 after Burge satisfied the terms of her probation.
When Burge moved to Florida in the early 1990s, she disclosed the Colorado conviction to state licensing authorities.
The Florida State Dental Board reviewed the details surrounding those charges at a special hearing in 1992. During the hearing, Burge submitted a written statement admitting that her fraudulent manipulation of claims at Comprecare gave her "a sense of having control and power."
At the time, several board members raised concerns about licensing Burge. But their questions evaporated after Burge explained her brush with Colorado law enforcement as the outgrowth of "emotional strain" caused by an "abusive" relationship with her then husband.
Her defense won the board over; the agency granted her a license to practice in her newly adopted state of Florida in 1993.
"They (board members) concluded that she had served her time for those charges and based on that fact felt she was rehabilitated," said Bill Parizek, a spokesman for Florida's Department of Health.
Parizek said he could not comment on whether the state's dental board has opened an investigation into the recent allegations against Burge. However, he acknowledged that the board had looked into Burge's background before.
Bavol, Burge's attorney, said the oral surgeon rebuilt her life after divorcing her husband and joining the Air Force. "That's behind her now," Bavol said.
Burge came to Florida in 1992 with an impressive resume. Harvard School of Dental Medicine, 1978-1982. An externship in plastic surgery at a German university. A residency at Temple University Hospital. A stint as a major in the U.S. Air Force.
She bought a home now valued at about $2-million on Park Street in St. Petersburg's Jungle Shores neighborhood. A white Humvee and a black Bentley are registered in her name.
Burge built a thriving practice at her Florida Centre for Facial Surgery at 5253 Central Ave. in St. Petersburg. She handled everything from dental implants to eye tucks and other cosmetic surgeries.
In October 1998, auditors with the state Agency for Health Care Administration (ACHA) warned her that she overbilled for operations. ACHA eventually ordered Burge to repay a little more than $105,000 for claims made between 1996 and 1997. The agency did not discipline her further after she returned the funds.
Despite the October 1998 citation from auditors, records indicate she ordered her office manager to continue submitting the fraudulent claims. Two of her former employees told investigators Burge would become "upset" and "make life miserable" if they failed to meet the oral surgeon's goal of billing Medicaid "at least $10,000 a day."
ACHA spokesperson Kim Reed said the agency has not revoked Burge's Medicaid operating license on the most recent charges, but since her arrest the agency has been reviewing her claims. "We are looking at each of Dr. Burge's claims under a prepayment review plan. An analyst will verify that the procedure has been done," Reed said.
Natalie Abruzzo, who was Burge's administrative assistant from 1998 to 2000, told investigators Burge frequently asked her to withdraw funds from her practitioner's operating account. She ordered Abruzzo to convert the bank checks into money orders and send them to Burge's Cayman Islands account. "I believe I handled approximately $30,000 to $35,000 in those transactions for Dr. Burge," Abruzzo said in a statement to investigators.
Burge also ran into trouble with the Florida State Dental Board after complaints surfaced that she had engaged in "misleading advertising" when she billed herself as a dermatologist and plastic surgeon in the phone book. The board, however, dismissed the charges in 1998 after Burge said her office manager forged Burge's signature when she negotiated the terms of the ad.
Records also show at least two of her patients sued her for malpractice. Burge's insurers settled the suits for $10,000 and $7,500 out of court.
The most recent fraud charges stem from bills that date as far back as 1998.
Lt. Patrick Nieman, an investigator with the state attorney's Medicaid fraud unit in Tampa, said Burge consistently charged for services she did not perform, overcharged for dental procedures and filed numerous claims for medications her patients never received.
According to a sworn statement from a patient who had gone to Burge for a routine tooth extraction, Burge told the patient she had accidentally broken her lower jawbone while removing her teeth.
When the woman returned to have an artificial bone placed in her jaw, Burge allegedly performed the procedure without the use of anesthesia. Investigators said there was no evidence of surgical cuts to the woman's jaw. Medicaid paid Burge $1,577.21 for the procedure.
Burge allegedly rang up thousands from follow-up procedures to mend what she broke. Records indicate Burge received close to $23,000 in overpayments for jawbone operations.
A trial date has not yet been set for Burge, but some of her patients are surprised by the turn of events.
"I thought she (Burge) had some really good credentials," said Lashley, Burge's former patient. "I was shocked."
-- Times staff writer Candace Rondeaux can be reached by telephone at (727) 893-8215 or by e-mail at Rondeaux@sptimes.com.
-- Times researcher Caryn Baird and Times staff writer Leanora Minai contributed to this report.
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