Jepsen alleges $24M Medicaid fraud

Nick Rees Jun. 4, 2012, 7:48am


HARTFORD, Conn. (Legal Newsline) - Conn. Attorney General George Jepsen named 28 individuals, dental practices and corporations in a civil action on Thursday, alleging an elaborate and illegal two-year, $24 million Medicaid fraud scheme.

Jepsen's suit alleges that Gary Anusavice of North Kingston, R.I.; Mehran Zamani of Pound Ridge, N.Y., and Stamford; Paul Anusavice of North Grafton, Mass.; John Gallagher of Manchester, Mass.; David Wu of Cheshire; and Alphonso Mack of Bloomfield violated the Connecticut False Claims Act and the Connecticut Unfair Trade Practices Act.

Anusavice and Zamani were arrested on federal criminal charges last week for their alleged involvement in the billing scheme.

"This is the first case the state has initiated under the Connecticut False Claims Act," Jepsen said. "It gives the state the rightful ability to seek compensation for taxpayers from those who seek to abuse the system with false claims for reimbursements they are not eligible to receive."

In July 1997, Anusavice, then a dentist, was convicted of a felony in Massachusetts for submitting false health care claims. He was permanently excluded by the U.S. Department of Health and Human Services from participation in Medicare and state health care programs, including Medicaid, after April 1998 as a result of his conviction. Anusavice and any entity with which he serves as an employee, administrator, operator or in any other capacity, were also excluded from state healthcare programs.

Despite the exclusion, Anusavice, through a series of corporations, allegedly established a number of dental practices in Connecticut that were operated by practicing dentists. The dentists applied to the Connecticut Medical Assistance Program to become providers or were providers and billed Medicaid for services in violation of the exclusion, Jepsen says.

According to the complaint, Anusavice was actively involved in managing the practices, receiving millions of dollars in Medicaid reimbursements.

Zamani, Wu and Mack, the dental providers, allegedly knew of Anusavice's ownership role and/or exclusion and did not disclose it on enrollment and re-enrollment forms for the Connecticut Medical Assistance Program.

The complaint also names the dental practices and other corporations created or controlled by the various individuals, including E.G.A. Management Inc., Haven Consulting Inc., AMZ Consulting Inc., Dental Care of Connecticut Inc., N.B. Dental Inc., Electron Marketing Inc. of Fall River, Mass., Dental Group of Stamford LLC and Dentists Group of Stamford PC.

Also named were Mehran Zamani LLC; Mehran Zamani, DDS, PC; Dental Group of Connecticut LLC; and Dentists Group of Connecticut PC; Dental Group of Waterbury LLC Dentists Group of Waterbury PC; Dental Group of Danbury PC; Dental Group of New Britain PC; Dental Group of Hartford PC; Hartford Dental Care LLC; Hartford Dental Incorporated PC; Arbor Dental Association LLC; Alpha Dental Group PC; and Wintonbury Dental Associates PC.

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