Dentists accused in Medicaid con
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MIAMI -- Cynthia Blue was terrified to learn that a stranger had taken her child to the dentist.
Her 12-year-old son, Alton, has a heart condition that requires medication for even the most routine dental care. When Blue learned last summer that a woman she had never met had taken him from a babysitter's yard to a dentist who knew nothing of his medical history, she called 911 and rushed him to a nearby hospital. The boy was unharmed.
Alton had become one of thousands of children in South Florida's poorest neighborhoods who prosecutors say have been delivered by recruiters to dentists for unnecessary and sometimes improper care in a multimillion-dollar scheme to defraud Medicaid.
The children, some as young as 2, were picked up from street corners and school-bus stops and taken to dozens of South Florida dental facilities for cleanings, X-rays, fillings and even extractions, authorities say. Many parents gave their consent because their children were getting free dental care, though some children were taken without permission.
Recruiters gave the children $5, Pokemon cards and trips to McDonald's. The recruiters received $25 for every child they brought in, authorities say.
Some youngsters were shuttled to different dentists every day for up to a month until their benefits ran out, investigators said. Each time they got more X-rays, which were frequently administered by untrained dental employees.
Yet after an investigation of more than two years that brought the arrests of the three men prosecutors say ran the scheme and 17 dentists and nearly 90 recruiters and dental workers, investigators said the scheme was continuing through word of mouth.
"Every time you arrest somebody they give you somebody else and it grows," said George Fiorenza, a supervising investigator with the state attorney general's Medicaid fraud unit.
But since the investigation began in late 1999, South Florida's annual Medicaid dental bill for children has been cut in half, to about $18-million, said Steven Kogan, regional chief of the state's Medicaid fraud division. Investigators say the scheme has cost taxpayers at least $20-million.
Kim Reed, a spokeswoman for the Agency for Health Care Administration, which administers Medicaid for the state, said abuses were often difficult to detect because Florida only recently began to limit and monitor the amount of certain benefits that recipients can get in a year.
Attorney General Bob Butterworth's office began its investigation into the scheme after receiving a tip from a prisoner seeking, unsuccessfully, to reduce his sentence for an unrelated child molestation conviction.
Investigators said recruiters who lived in or were familiar with poor neighborhoods canvassed the areas looking for patients. Often, investigators said, the recruiters first approached parents and tried to determine if the children had Medicaid benefits.
"The parents initially probably thought it was a good thing," Fiorenza said. "They think, "My kid gets to go to the dentist, they get a free ride and I get a babysitting service for the evening and my kid gets five bucks.' If the parents were reluctant, they could be offered $5 as well."
What the parents did not know, Fiorenza said, was that many of the recruiters had prior convictions for narcotics crimes, child molestation and even murder. And the parents were unaware that their children were being used to bill the state for illegitimate dental care or that doctors substituted the X-rays and dental charts of children ineligible for Medicaid with those of eligible patients who did not regularly use their benefits, Fiorenza said.
Under Medicaid, recipients younger than 21 are entitled to dental checkups and cleanings twice a year and a limited amount of other treatments.
Like the recruiters of Blue's children, most of the dentists and dental workers arrested have been charged with multiple counts of illegal solicitation of Medicaid patients or Medicaid provider fraud. One count of either charge carries a maximum penalty of five years in prison and a $5,000 fine.
But Joel Berger, the man who authorities say was the ringleader of the scheme that began in the late 1990s, contends that prosecutors have wrongly gone after people who are simply providing a service.
Berger has been charged with multiple counts of Medicaid fraud, racketeering and conspiracy to commit racketeering.
Berger, a former dentist in Queens, N.Y., had his dental license revoked for gross negligence, incompetence and unprofessional conduct in 1990, according to New York state records. Florida authorities say Berger set up the dental offices in Miami-Dade, Broward and Palm Beach counties but did not practice.
Authorities say Berger set up licensed dentists in practice and paid them $500 a day to treat young Medicaid recipients. The dentists then gave Berger control of bank accounts in which Medicaid checks were deposited, the authorities said, and he then kept the balance of the money.
Berger maintains that any money he made facilitating the treatment of children was earned legally. "I would bring patients who were Medicaid-eligible to various dentists to have services performed, that's all," he said. "They call me a ringleader. Well I didn't even know there was a ring."
Prosecutors contend that Berger and two men who helped him organize the scheme were responsible for most of the fraud. Investigators identified the other two as Charles Kravitz, a former dentist from Pennsylvania with an expired license, and Gabriel Reginald Harden, who they say was a middleman in Berger's operation office.
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From the Times state desk
From the state wire