Wednesday, August 28, 2013

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Abilene Dentist Faces Up to Five Years in Prison for Health Care Fraud in Case Investigated by State and Federal Officials

The United States Attorney for the Northern District of Texas issued the following news release on August 27, 2013:

Abilene Dentist Pleads Guilty in Medicaid Fraud Scheme
Defendant Worked as a Pediatric Dental Provider at Kool Smiles and Personally Benefitted From Scheme

ABILENE — A dentist who practiced pediatric dentistry at Kool Smiles in Abilene, Texas, has admitted that he made false and fraudulent statements and entries on patient records, which caused Medicaid to be billed for, and pay, at least $120,000 for services falsely claimed to have been performed, announced U.S. Attorney Sarah R. Saldaña of the Northern District of Texas.

Dr. Tuan Truong, aka “Terry Truong,” of Abilene, pleaded guilty this afternoon, before U.S. District Judge Jorge A. Solis, to an information charging one count of making a false statement in connection with a health care matter. Truong, who will remain on bond, faces a maximum statutory penalty of five years in federal prison, a $250,000 fine and restitution. A sentencing date was not set.

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.

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, is in charge of the prosecution.