Wisconsin Dentist Convicted of Health Care Fraud and False Statements

On Friday, a Wisconsin dentist was convicted on five counts of health care fraud and two counts of making false statements that were related to healthcare matters. The U.S. Attorney’s Office in the Eastern District of Wisconsin’s release said that the federal jury found the Grafton dentist Scott Charmoli guilty of the charges.

Charmoli had a money spinning scheme going on that netted him tremendous profits as he defrauded dental insurance companies for years together. According to the release, the dentist began this journey into fraud from 2015. He used to convince patients that they needed crowns in their teeth. Then he would break the teeth using his drill. After the procedure, he would take pictures and X-rays of the broken teeth.

Armed with these pictures as evidence, the dentist would request insurance companies to pay for the procedures. These companies would assume that the teeth were broken before the procedures and would pay up. Many of the dental patients were also co-pays for these procedures.

Data from just one insurance company showed that Charmoli performed more crown procedures than most dentists in the state. The number of crown procedures performed by the 61-year old dentist from 2016 to 2019 were in the 95 percentile of crown procedures in all these years. He also earned more than $4.2 million between 2016 and 2019.

Evidence presented by the prosecutors show that he performed more than 700 crowns each year from 2015 to 2019. During the course of two years—2015 and 2016 the number of crown procedures crossed 1000 each year. According to the latest US Census estimates the population of Grafton, Wisconsin, where the dentist lives is 11,595.

United District Court Judge Lynn Adelman will pronounce the sentence on the 61-year old dentist on June 17, 2022. He faces maximum ten years in prison for each healthcare fraud conviction whereas each false statement conviction can get him a maximum five-year prison term.

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