Indictment Charges Alleged Dental Clinic Operator Involved in $20 Million Medicaid Fraud Scheme
|U.S. Attorney’s Office June 11, 2012|
David B. Fein, United States Attorney for the District of Connecticut, today announced that a federal grand jury in New Haven has returned a nine-count indictment charging Gary F. Anusavice, also known as “Gary Andrews,” “Gary Andrus,” and “Gary Francis,” 59, of North Kingstown, Rhode Island, with various offenses related to his involvement in a $20 million Medicaid fraud scheme. The indictment was returned on June 7, 2012. Anusavice has been detained since his arrest on May 24, 2012.
“By surreptitiously operating dental clinics in Connecticut, this defendant allegedly defrauded the Medicaid program of more than $20 million over a two-year period,” said U.S. Attorney Fein. “We are committed to protecting American taxpayers from health care fraud, which can increase costs and jeopardize the integrity of our health care system. I want to commend HHS-OIG, IRS-Criminal Investigation, and the FBI for their investigative efforts and thank the Connecticut Attorney General’s Office, which provided invaluable assistance during the course of this investigation.”
According to the indictment, the Medicaid program is a joint federal-state program that provides funds for medical services to lower-income individuals who qualify for benefits. The program is jointly administered by the U.S. Department of Health and Human Services and supervised by the Centers for Medicare and Medicaid Services. In Connecticut, the Medicaid program is administered by the State of Connecticut Department of Social Services (DSS).
The indictment alleges that Anusavice was previously a registered dentist in Massachusetts and Rhode Island. In July 1997, Anusavice sustained a felony conviction in Massachusetts for submitting false health care claims and was subject to disciplinary proceedings in both Massachusetts and Rhode Island. Based on Anusavice’s Massachusetts disciplinary proceedings, the U.S. Department of Health and Human Services notified Anusavice in April 1998 that he was being excluded from participation in Medicare and state health care programs, including Medicaid. As part of that notice, Anusavice was informed that, as an excluded individual, he may not “submit claims or cause claims to be submitted” for payment from the federal Medicaid program. Further, Anusavice was advised that Medicaid reimbursement payments are prohibited to any entity in which he serves as an “employee, administrator, operator, or in any other capacity.”
In November 2005, Anusavice surrendered his right to practice dentistry in Rhode Island for 18 months, and the Massachusetts Board of Registration in Dentistry permanently revoked Anusavice’s license to practice dentistry in Massachusetts in 2006.
The indictment alleges that, from 2009 to April 2011, Anusavice owned and operated several dental clinics in Connecticut but used a licensed dentist, who is referred to in the indictment as “Co-Conspirator 1,” to act as the nominal head of the dental clinics. The clinics included Landmark Dental in West Haven, Dental Group of Connecticut in Trumbull, and Dental Group of Stamford. After Co-Conspirator 1 provided false Medicaid Provider Enrollment Applications to DSS, which failed to disclose Anusavice’s ownership or control interest in the dental clinics and Anusavice’s disciplinary history, the dental practices received nearly $21 million in Medicaid reimbursements from the Connecticut Medicaid program, which payments were prohibited given Anusavice’s exclusion from the Medicaid program. Anusavice, in turn, received more than $3 million in payments from the clinics through nominee entities that he controlled.
As alleged in a previously filed criminal complaint, at the dental clinics, Anusavice was involved in reviewing patient charts, suggesting dental procedures to be performed, reviewing billing records, reviewing income reports, interviewing and hiring dentists, and providing overall management direction to the offices.
The indictment charges Anusavice with conspiring with others to fraudulently obtain money from the Connecticut Medicaid program by submitting Medicaid claims and concealing and misrepresenting Anusavice’s prior disciplinary and criminal history, his ownership interest in the dental clinics, and his exclusion from the Medicaid program. This charge carries a maximum term of imprisonment of five years.
The indictment also charges Anusavice with one count of health care fraud, which carries a maximum term of imprisonment of 10 years, and two counts of wire fraud, which carry a maximum term of imprisonment of 20 years, on each count. Anusavice also is charged with four counts of making false statements involving the Medicaid Program, and one count of concealment and failure to disclose an event affecting the Medicaid Program. Each of these charges carries a maximum term of imprisonment of five years.
The indictment also seeks the forfeiture of Anusavice’s Rhode Island home, his 2008 Mercedes automobile, and $91,700 in cash that was seized at the time of his arrest.
U.S. Attorney Fein stressed that an indictment is not evidence of guilt. Charges are only allegations, and each defendant is presumed innocent unless and until proven guilty beyond a reasonable doubt.
This matter is being investigated by the U.S. Department of Health and Human Services, Office of Inspector General; the Internal Revenue Service-Criminal Investigation; and the Federal Bureau of Investigation. The Connecticut Attorney General’s Office provided assistance and cooperation throughout the investigation.
This case is being prosecuted by Assistant United States Attorneys Susan Wines and Richard Molot and Special Assistant United States Attorney Sean Beaty. U.S. Attorney Fein encouraged individuals who suspect health care fraud to report it by calling the Health Care Fraud Task Force at 203-777-6311 or 1-800-HHS-TIPS.