I-Team: Dentist Accused Of Billing State For Procedures Never Performed
BOSTON (CBS) – Without the help of the MassHealth dental program, thousands of local children and families would have nowhere to turn for basic dental care.
“Our paid claims for calendar year 13 is a little over $260 million,” said Dr. Brent Martin, the MassHealth Dental Director.
But in recent years, the I-Team discovered not all of that money went to care for needy patients.
Take Dr. Shahrzad Haghayegh-Askarian who has an office in Quincy.
“What she did is just unconscionable,” State Auditor Suzanne Bump said. “It’s clear to my auditors that she simply was bilking the MassHealth system.”
Bump found Dr. Shaw, as she calls herself, filed hundreds of bogus claims for procedures that were not allowed or never even performed. Dr. Shaw billed MassHealth for $154,000 in unallowable restorations, denture repairs and unnecessary fluoride treatments.
“In fact there was one patient and she billed for 53 separate fluoride treatments,” Bump said.
Dr. Shaw didn’t return our calls and refused to speak with us on the phone or when we went to her office. An I-Team producer caught up with Dr. Shaw a few days later, but again, she refused to answer our questions.
So how could the state possibly let these types of fraudulent billing slip through the cracks?
“The fact is I don’t think there is any excuse for 53 fluoride treatments in one patient,” Dr. Martin said.
While Dr. Martin says MassHealth is ultimately responsible, he placed much of the blame on a third party contractor hired by the state to process the claims.
“By seeing the findings by the office of the State Auditor, we knew we had things to go fix, which we did,” he said.
Dr. Shaw was one of ten dentists state auditors found to have fraudulently billed the system for a total of $1.3 million. She was the only dentist who refused to cooperate with the auditors.
Dr. Martin says many of those loopholes that allowed those payments to go through have now been closed. And he has a message for anyone who tries to get away with it in the future. “We will find you,” he said.
As for Dr. Shaw, she’s now under investigation by the Attorney General’s office. Her license has also been suspended by the state, because of patient complaints of poor care.