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June 18, 2015 Medicaid Fraud

Atlanta Dentist to Pay Over $320,000 to Settle Allegations of Improper Medicaid Billing

Healthcare fraud cases are not limited solely to medical doctors. Misconduct among dentists and oral surgeons is also a major issue plaguing government-funded healthcare programs. In today’s case, we review a recent instance of healthcare fraud involving an Atlanta-area dentist alleged to have submitted false claims to Medicaid for procedures that either did not take place, were not properly supervised, or were medically unnecessary. In other words, it’s the same old story, but a different industry.

The case was initially investigated by the F.B.I. following a whistleblower allegation made confidentially by a former employee of the practitioner. From there, investigators from the Department of Health and Human Services became involved, along with the U.S. Attorney’s Office for the Northern District of Georgia.

Overall, the dentist has agreed to pay $324,327.05 to settle the claims, which will be split between the federal government (set to receive $190,635.67) and the State of Georgia, which administers a portion of the Medicaid funding involved in the fraud.

Details of the allegations against Dr. Dennis Jaffe

Dr. Dennis Jaffe, the self-proclaimed Atlanta ‘Downtown Dentist,’ is alleged to have performed a number of medically unnecessary dental extractions, thereafter billing Medicaid for the procedures and increasing profit margins all the while. In addition, the dentist is alleged to have violated the Medicaid guidelines, which requires constant supervision by a licensed dentist over procedures performed by dental assistants. More specifically, Dr. Jaffe is alleged to have allowed his dental assistants to perform intricate dental procedures while he was not even present on the premises.

In addition to his six-figure settlement with the federal and state governments, Dr. Jaffe was sentenced to a one-year criminal probation and lost his license to practice dentistry indefinitely. He is further permanently barred from enrollment in Medicare and Medicaid should he ever regain the right to practice dentistry in Georgia or elsewhere.

Government officials weigh in on the case

The settlement with Dr. Jaffe sparked several responses from government officials, including the following from the U.S. Attorney’s Office: “Citizens rely on dentists to treat all patients in accordance with the approved standards of care….Patients were placed at risk when a dental assistant, without Jaffe present to supervise, performed procedures a licensed dentist must oversee. The defendant also enriched himself at the expense of those patients by marking up the bills to Medicaid for the services he was not performing.”

The Department of Health and Human Services similarly weighed in, stating, “All patients should be entitled to the same level of care and providers who choose to cut costs and increase profits by using unlicensed staff bring shame upon the entire profession and more importantly jeopardize the safety of patients….Dr. Jaffe’s case should stand as a warning to those who choose to put profits above patient care.”

Contact Berger Montague today

If you are aware of ongoing Medicare or Medicaid fraud, please do not hesitate to contact Berger Montague for thorough and confidential whistleblower representation.