A Charleston dental practitioner on Monday pleaded guilty to federal charges that he incorrectly billed Medicaid for more than $700,000 in oral treatments he did not, in fact, carry out on his clients.
Antoine Skaff, 58, pleaded guilty to healthcare scams before U.S. District Judge Joseph R. Goodwin in the Robert C. Byrd United States Courthouse in Charleston. He also participated in a civil settlement with federal government firms in which he will need to pay $2.2 million, or 3 times the loss suffered by West Virginia Medicaid, Assistant United States Attorney Clint Carte stated in a press release.
Part of Skaff’s plea offer for the criminal charges will include him paying $738,067 in restitution, which remains in addition to the payments for the civil settlement, and he will confront 10 years in jail when he is sentenced on Nov. 13.
Skaff confessed Monday to fraudulently billing West Virginia Medicaid and West Virginia Medicaid Managed Care Organizations for more than $700,000 throughout a period of more than 5 years, Carte stated.
Skaff confessed he incorrectly inflated his billing, a practice described as “upcoding,” which he frequently did by incorrectly declaring repayment for treatments including affected teeth, Carte stated. Skaff wrongly notified Medicaid that he carried out more complicated treatments on his clients, such as an extraction of an affected tooth, when he, in fact, carried out less intricate treatments, like the easy extraction of a tooth. Skaff confessed to upcoding at least 7,490 tooth extractions, billing more than $1.3 million for those treatments, Carte stated.
Based upon the treatments he, in fact, carried out, Skaff needs to have billed for $599,200 in the offered time span, Carte stated.
Skaff also confessed he would send incorrect expenses and get payment two times for finishing one treatment, and he got $56,930 from the double billings, Carte stated.
As part of Skaff’s $2.2 million civil settlement, he also will be left out from Medicare and Medicaid programs for 13 years, which means he will not have the ability to costs either entity throughout that time frame. Carte stated.
The West Virginia Medicaid Fraud Control Unit, the FBI, the Office of Inspector General for the United States Department of Health and Human Services, and the Affirmative Civil Enforcement private investigator from the United States Attorney’s workplace performed the examination.