Conn. AG files suit against dental practice over billing

Bryan Cohen May 29, 2012, 7:00am


HARTFORD, Conn. (Legal Newsline) - Connecticut Attorney General George Jepsen filed a lawsuit on Thursday against a Winsted dentist and his practice for allegedly violating the state's Unfair Trade Practices Act by engaging in illegal billing.

Douglas J. Macko and his Southington-based professional corporation, Douglas J. Macko, D.M.D., P.C., allegedly illegally billed the Connecticut Medical Assistance Program between April 2002 and October 2009. Macko allegedly had unlicensed dental assistants perform cleanings and other dental services and billed the state as if he had performed the services personally. He also allegedly billed the program for services that were never provided.

The Connecticut Department of Social Services administers the Connecticut Medical Assistance Program. The program is made up of Medicaid and other programs that pay for medical benefits to certain disabled and low-income state residents. The DSS terminated Macko's provider agreement and suspended him from the program for 10 years on October 26, 2010.

The lawsuit alleges that the practices, acts and wrongful conduct by Macko represented vendor fraud, health insurance fraud and the violation of public policies against larceny and licensing requirements.

"This action is being brought to seek restitution, civil penalties and other relief authorized by law," Jepsen said. "It should also send a clear message to other providers that Connecticut will not ignore fraudulent billing and other illegal practices and will vigorously pursue restoration of taxpayer dollars lost as a result."

Jepsen brought the action at the request of William Rubenstein, the consumer protection commissioner, and as a result of a referral by the DSS.

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