Dentists Bilked System; Performed Unnecessary Dental Work on Unsuspecting Patients
(SACRAMENTO) – Attorney General Bill Lockyer today filed criminal complaints against 20 dentists throughout the state, charging them with defrauding the state Medi-Cal System of $4.5 million, health benefits and workers' compensation fraud, conspiracy, grand theft, child abuse, elder abuse, assault and intentional infliction of great bodily injury.
"These dentists put at risk the health and well-being of hundreds of children and adults by performing slipshod dental services that were unnecessary, ignoring health problems that needed tending, and even skimping on appropriate amounts of anesthesia before submitting patients to painful procedures," Lockyer said. "This office will continue to aggressively prosecute those who rip off the Medi-Cal system that more than 6 million poor and elderly Californians depend on for vital health care."
Filed in Stanislaus County Superior Court, the complaint charges Modesto dentist Kyon Maung Teo, who owns Hatch Dental clinics in Ceres, Stockton and Modesto, with being the mastermind of a scam involving dentists from throughout the state. The complaint alleges Teo, 42, placed advertisements on the back of missing-children flyers and in PennySaver and DollarSaver publications. The advertisements offered gifts or rebates to Medi-Cal beneficiaries and "new patients" who sought services at Hatch Dental.
The investigation by the Attorney General's Bureau of Medi-Cal Fraud and Elder Abuse (BMFEA), assisted by the California Department of Health Services (DHS) showed Teo recruited 19 other dentists, who were paid about 25 percent of the insurance proceeds received by Hatch Dental for the work they performed. The kickbacks provided an incentive to perform unnecessary dental procedures of poor quality, including unnecessary filings and even unnecessary root canal procedures. It was not uncommon for a patient to walk out of Hatch Dental with 20 or more unnecessary fillings. To help increase billings, dental assistants also were instructed to perform procedures such as cementing crowns, which lawfully can only be performed by licensed dentists.
Co-defendant Kin Thor Pang, Teo's wife, was the office manager for all three Hatch Dental clinics. The complaint alleges Pang, 33, trained office staff to complete false dental claims, including changing dates of service or billing Medi-Cal and private insurance companies for "emergency" office visits if the patients were ineligible for routine coverage at the time of service.
The Hatch clinic staffs also were trained to fabricate periodontal charts and prepare Treatment Authorization Requests (TARs) to obtain Medi-Cal reimbursement for services based on the fabricated charts. Claims also were submitted for visits that never occurred and for non-existent procedures purportedly performed during the fabricated office visits. Insurance billing clerks were docked a dollar from their paycheck for each "mistake" they made.
As part of the conspiracy to defraud the Medi-Cal system, the dentists committed acts injurious to public health, placing the patients at risk of pain, infection, loss of teeth and great bodily injury, including: reusing dental instruments without sterilizing them, developing treatment plans that called for unnecessary dental surgeries such as root canals and fillings, performing dental surgeries without considering the patient's medical history, providing numerous shallow fillings in lieu of comprehensive treatment to patients in need of such treatment, issuing prescriptions for Schedule III narcotics without documenting the source and type of pain, forcibly restraining children during dental operations, performing extensive dental treatment on minors without fully disclosing the extent of the treatment to the minor's parent or guardian and performing dental surgeries without adequate anesthesia.
As the result of a separate investigation conducted by the California Department of Insurance, Teo and Pang also are charged with committing Workers' Compensation premium fraud by grossly understating the salaries of Hatch employees. The under-reporting resulted in a loss of $948.19 to Superior National Insurance Company, and $9,154 to Everest National Insurance Company.
Other dentists named as defendants in the complaint are:
Patients who believe they have been victimized by the Hatch Dental clinic dentists are urged to contact the Attorney General's Medi-Cal Fraud Hotline number at 1-800-722-0432.