Prosecutors said that a Wisconsin dentist had broken the teeth of his patients for years and charged them for a crown to repair the damage.
Scott Charmoli, a dentist, filed claims with insurance companies, bringing in millions of dollars.
Charmoli, 61 was the administrator of the scheme from 2015 to 2019, when he sold Jackson Family Dentistry.
He was charged with several offenses in late 2020. According to a newsrelease from the U.S. Attorney's Office in the Eastern District of Wisconsin, the jury convicted him of five counts of fraud related to healthcare and two counts of making false representations related to healthcare.
Prosecutors claimed that Charmoli tried to persuade his patients to have crown procedures in 2015, even though they didn't need them.
According to the indictment, he would show his patients an Xray of a spot or line on their teeth and inform them that it was either a fracture or some other type of decay. The crown is a procedure that fixes a tooth using a cap. After the patient had agreed, he used his drill to remove a portion of the patient’s tooth and fix it.
According to the indictment, Charmoli would then submit another X-ray to the insurance company.
"Insurance companies assumed those images of damage represented pre-operative conditions of the teeth and paid the claims. The news release stated that Charmoli's patients often had to pay significant co-pays for crown procedures.
He would submit X-rays and make false statements to insurance companies when they denied him claims.
Prosecutors have revealed that Charmoli charged more than $4.2million for crown procedures from one insurance company between 2016 and 2019.
Evidence gathered during the investigation shows that he performed more than 1,000 crowns in each of 2015 and 2016. He performed over 700 crowns each year from 2017 to 2019.
Charmoli's trial witness Todd Tedeschi, a former patient, said that Charmoli convinced him to have two crowns done simultaneously even though his teeth weren't bothering him. According to the Milwaukee Journal Sentinel.
Tedeschi stated that it seemed exaggerated, but that he didn't know better. He was the professional. I just trusted him."
According to the newspaper, Charmoli had his license suspended in February 2021 while he was being investigated by the state's Dentistry Examining Board. Nearly 100 former patients brought medical malpractice lawsuits against Charmoli in Washington County. These suits were put on hold while the federal criminal case is resolved.
Pako Major, who is now the owner of Jackson Family Dentistry, stated in a 2020 note, that Charmoli's conduct was discovered after reviewing patient files.
As a doctor, my greatest concern is the safety and health of my patients. He wrote that medical professionals are required to take an oath to do no harm to patients. Therefore, he felt an ethical obligation to report suspicious activity. "My heart goes out for any patients who were mistreated in this circumstance. My goal is to rebuild trust and faith in dentistry by providing excellent care and customer service.
Charmoli's lawyer, Nila Robinson could not be reached immediately on Wednesday. She denied the charges against Charmoli during a 2020 arraignment.
According to court documents, Nila Robinson stated that "he certainly denies" that his hard-earned wealth over many, many years in dental practice, working 40-60 hours per week, was the result of any other than his diligence, hard work, and good business acumen.
Charmoli is due to be sentenced in June. Charmoli faces a maximum sentence of 10 years for each conviction for healthcare fraud and five for each conviction for false statements.
