Thursday, February 6, 2014

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Abilene Dentist Ordered to Prison for Health Care Fraud in Case Investigated by State and Federal Officials

The U.S. Attorney for the Northern District of Texas issued the following news release on Feb. 5, 2014:

Abilene Dentist Sentenced to 18 Months in Federal Prison and Ordered to Pay Nearly $58,000 in Restitution in Medicaid Fraud Scheme

Defendant Worked as a Pediatric Dental Provider at Kool Smiles and Personally Benefitted From Scheme

ABILENE, Texas — Dr. Tuan Truong, aka “Terry Truong,” of Abilene, a dentist who practiced pediatric dentistry at Kool Smiles in Abilene, was sentenced this afternoon, by U.S. District Judge Jorge A. Solis, to 18 months in federal prison.  Truong pleaded guilty in August 2013 to an Information charging one count of making a false statement in connection with a health care matter.  Truong was also ordered to pay $57,969 in restitution to Kool Smiles.  Today’s announcement was made by U.S. Attorney Sarah R. Saldaña of the Northern District of Texas.

According to documents filed in the case, in summer 2008, Truong began working for Kool Smiles, which paid him a base salary and offered opportunities for bonuses based on additional procedures he performed in excess of daily targets set by Kool Smiles management.  Dentists were required to use professional judgment in the treatment and management of patient care.

Beginning on June 30, 2008, and continuing to July 10, 2009, Truong made false entries on Kool Smiles patient records, purporting to have performed dental services for Medicaid beneficiaries that he well knew he had not performed.  As a result of the false and fraudulent statements and entries Truong made, Kool Smiles billed Medicaid for procedures that were not performed.  In fact, during this time period, Truong made false entries in the Kool Smiles electronic database that caused Kool Smiles to bill and receive payment from Medicaid (and Medicaid affiliates) of more than $120,000, but less than $200,000 for services he claimed to have performed, but did not. 

In addition, according to the factual resume filed, Truong personally benefitted from this scheme by receiving bonuses of $32,749 to which he would not have been otherwise entitled.  The court also ordered Truong to reimburse Kool Smiles for the legal fees incurred during the investigation.

Kool Smiles has cooperated throughout the investigation, which was conducted by the Texas Attorney General's Medicaid Fraud Control Unit and the FBI.  Assistant U.S. Attorney Amy Burch, of the U.S. Attorney’s Office in Lubbock, Texas, was in charge of the prosecution.