An oral surgeon from McAllen, Texas is on trial for receiving $4.6 million in fraudulent Medicaid claims over a three year period from January 2007 to April 2010.
Medicaid claims appear to be ripe for unscrupulous healthcare providers to abuse. Often, officials are overwhelmed and lack the resources for oversight of the millions of claims that are submitted each year. In many cases, physicians either submit claims for work they never performed, or hire unlicensed or unqualified personnel to perform the work.
In this case, the surgeon, Dr. Gary Morgan Schwartz, was alleged to have performed oral surgery in the offices of dentists who referred patients to him and then kicked backed portions of the Medicaid billings to the referring dentists.
Dr. Schwartz purportedly had unqualified dental assistants sedate patients before performing procedures in settings in which he was not licensed to operate. He then charged excessive fees for wisdom teeth extractions.
An undercover informant who worked as an intern secretly recorded video that reportedly shows Dr. Schwartz removing all four wisdom teeth from children and then dismissing them from his office while they were still under the effects of the anesthesia. The procedures were allegedly performed in about 20 minutes.
Dr. Schwartz faces 22 counts of conspiracy and fraud and faces up to 10 years in prison. His personal assistant may be testifying against him in return for leniency. Prosecutors had earlier dismissed charges against Dr. Schwartz’s office assistants and other dentists.