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Southington, Connecticut Dentist Agrees to Plead Guilty to Medicaid Fraud and Pay $55 Thousand to Settle Alleged False Claims Act Violations

Individuals have certainly not been unrepresented when it comes to the Federal government’s recent crackdown recent on Medicaid and Medicare fraud cases. Case in point: A Southington, Connecticut dentist – Dr. Thomas DeRienzo – has agreed to pay $55 thousand to resolve the violations of the False Claims Acts filed against him by The Attorney General’s office. DeRienzo – owner of Plantsville Family Dental – is alleged to have billed Medicaid for procedures that were either not needed or for which he had “upcoded”. (Upcoding is when an incorrect billing code is assigned to a medical procedure to increase the reimbursement amount.)

The incidences are alleged to have occurred between January 2010 and August 2014. In August of 2014, DeRienzo was charged with first-degree larceny by defrauding a public community, second-degree vendor fraud and insurance fraud. These charges are still pending in Hartford Superior Court and the case has been ordered sealed. Attorney General George Jepsen said in a statement. “By bringing state False Claims Act cases such as this, we recover funds obtained through fraud and deter others from attempting similar schemes.”

The case was part of the state’s Interagency Fraud Task Force, which was created in July 2013 to proactively investigate healthcare fraud. The Obama administration has spearheaded a larger crackdown on Medicaid and Medicare fraud with an initiative that has been active since 2009 and which has recovered over $3.5 billion from False Claims Act cases in the fiscal year of 2015. Persons, who feel they are entitled to Medicare fraud whistleblower protection, should seek out the counsel of a qui tam lawyer.