Agreement Ensures Compliance with New York State False Claims Act and Education Laws.
New York, NY - January 15, 2019 - Attorney General Letitia James announced today a $9 million settlement with “Diamond Braces” for allowing uncertified employees to perform orthodontic procedures and then improperly billing Medicaid for payment for such procedures. “Diamond Braces” is a chain of dental offices operating in twelve locations in New York State, including dental offices in all five boroughs and in Nassau and Rockland Counties.
“It is unacceptable that uncertified individuals would ever perform orthodontic work in New York,” said Attorney General Letitia James. “Diamond Braces falsely billed Medicaid for these services, cheating our state out of millions of dollars. We will never tolerate these deceptive business practices that break the laws designed to keep patients safe.”
In the settlement, Oleg Drut, DDS, and Diamond Braces admitted that Diamond Braces employees who were uncertified by the New York State Education Department (“NYSED”) performed some intraoral procedures. Drut and Diamond Braces also admitted to certifying to the Medicaid program that the individuals who performed services patients had the necessary certifications to perform the claimed services. New York State laws, including the Education Law and its implementing regulations, prohibit employees who are not properly certified from performing intraoral orthodontic procedures.
In order to ensure future regulatory compliance, the settlement agreement requires Drut and Diamond Braces to enter into a corporate integrity agreement or retain an independent monitor, who will report to the State and confirm that Diamond Braces complies with the law. The settlement agreement also requires Drut and Diamond Braces to pay $9 million to the Medicaid program, of which $4.5 million is restitution for the underlying conduct and an additional $4.5 million in penalties.
The New York State Education Law and supporting regulations set forth education, clinical experience, and testing requirements for dental assistants to be certified by the NYSED. The law also identifies specific procedures that certified dental assistants may perform, known as scope of practice rules. Laypeople who are not certified by the NYSED may not perform any of these tasks or any other tasks falling within the scope of practice of other licensed professionals such as hygienists and dentists. These limitations prohibit uncertified laypeople from performing any work inside patients’ mouths.
MFCU’s investigation did not uncover any evidence that patients were injured from the violations.
The investigation was investigated by Supervising Investigator Ronald Lynch, Investigators Shavaun Clawson and Timothy Connolly with assistance from Deputy Chief Investigator Kenneth Morgan. Senior Auditor-Investigator Kizzy-Ann Waldropt and Auditor-Investigators Brian Gonell and Corinne Rondina conducted financial analysis under the supervision of NYC Regional Chief Auditor Thomasina Smith. Investigative support was provided by Confidential Legal Analyst Victoria L. Sepe.
Special Assistant Attorneys General Felicia Berenson-Reinhardt, Todd Pettigrew, Ting Ting Tam, and Alee N. Scott handled the case with the assistance of MFCU’s Chief of Criminal Investigations – Downstate Thomas O’Hanlon and MFCU’s Civil Enforcement Division Chief Carolyn Ellis. MFCU is led by Director Amy Held and Assistant Deputy Attorney General Paul J. Mahoney. MFCU is within the Attorney General’s Criminal Justice Division.