Original Article here: https://www.justice.gov/usao-wdmo/pr/former-dental-clinic-owners-indicted-1-million-health-care-payroll-tax-fraud
SPRINGFIELD, Mo. – Tammy Dickinson, United States Attorney for the Western District of Missouri, announced today that Marshfield, Mo., husband and wife have been indicted by a federal grand jury for their roles in health care fraud and payroll tax fraud schemes that totaled more than $ 1 million.
Pamela Van Drie, 57, and her husband, Lorin G. Van Drie, 57, both of Marshfield, were charged in a 40-count indictment returned under seal by a federal grand jury in Springfield, Mo., on Wednesday, Nov. 2, 2016. That indictment was unsealed and made public today upon the arrest and initial court appearance of Pamela Van Drie.
Pamela and Lorin Van Drie were the owners of All About Smiles, LLC, a Springfield company that provided dental services at clinics in Springfield (until it closed in November 2015), Mountain Grove, Mo., (until it closed in October 2014) and Bolivar, Mo. (until it closed in March 2014). They also owned PL Family Management Company, LLC, which managed the staff for those clinics.
Today’s indictment alleges that Pamela Van Drie participated in a conspiracy to commit health care fraud from Oct. 6, 2010, to Aug. 19, 2015. According to the indictment, this conspiracy consisted of a fraud scheme related to dentures and other dental services and a fraud scheme related to orthodontic appliances. Both fraud schemes involved fraudulent Medicaid claims and payments.
Pamela Van Drie and a dentist at the clinics arranged for All About Smiles to provide dentures and other dental services to adults who did not qualify for Medicaid reimbursement. They allegedly submitted claims to Medicaid for those dentures and other dental services, knowing that Medicaid’s requirements were not met.
The indictment alleges that Pamela Van Drie, through All About Smiles, submitted and received $ 720,048 on numerous claims for dentures and other dental services that lacked the required written referral from a physician.
Additionally, according to the indictment, Pamela Van Drie and a dentist at the clinics purchased Oroth-Tain orthodontic appliances (designed to straighten teeth without braces) for approximately $ 50 each, provided them to Medicaid pediatric beneficiaries and billed each such appliance to Medicaid as a speech aid prosthesis for approximately $ 695. They knew the Ortho-Tain appliances should have been billed to Medicaid as orthodontic services, the indictment says; they also knew Medicaid did not cover orthodontic services unless the Medicaid program’s requirements were met and they received precertification, which required review by a dentist/orthodontist employed by Medicaid. They allegedly billed the Ortho-Tain appliances as speech aid prostheses in order to bypass the precertification requirement.
Between Oct. 6, 2010, and Aug. 19, 2015, Pamela Van Drie submitted and received payment for approximately 241 claims submitted for speech aid prosthesis. On each claim, All About Smiles was paid between $ 675 to $ 695, for an approximate total amount of $ 165,700.
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