A Wisconsin dentist has been convicted of health care fraud after he purposely damaged his patients’ teeth so he could bill insurance companies for crown procedures.
Scott Charmoli, 61, was also convicted of making false statements related to health care matters in the scheme from 2015 to 2019, according to the US Attorney’s Office for the Eastern District of Wisconsin.
The Grafton resident attached more than 1,600 crowns over a 20-month period, the Milwaukee Journal Sentinel reported.
On average, Wisconsin dentists installed fewer than six crowns per 100 patients, but in 2019, Charmoli’s rate exceeded 32 per 100 patients, an insurance company executive testified, according to the outlet.
The scheme was uncovered after Charmoli sold his practice in 2019, and the new owners realized after reviewing files that the crown numbers were out of whack.
His sentencing is scheduled for June 17 and he faces up to 20 years in the slammer.
Charmoli also faces medical malpractice lawsuits in Washington County, brought by nearly 100 former patients whose cases have been stayed pending the outcome of the federal case, the news outlet reported.
His license to practice dentistry in Wisconsin has been suspended since February 2021 pending a probe by the state’s Dentistry Examining Board.
Charmoli would show a patient an X-ray of a healthy tooth, but point to a line or a spot he said indicated a fracture or decay – and then would say a crown was needed, according to the indictment.
“Patients, who believed Charmoli was the expert, accepted his false representations and agreed to the crown procedure,” the indictment said.
After breaking the tooth, he took X-rays that accompanied a claim submitted to insurance.
Crown procedures are generally not fully covered by insurance, so the dentist did not receive full reimbursement for the claims and his patients had to make sizable co-payments, according to the Journal Sentinel.
Charmoli received $318,600 out of $745,570 in claims submitted to Delta Dental between Jan. 1, 2016, and June 28, 2018, the indictment said.
He also received another $114,294 on claims during the first six months of 2019, the document states.
Former patient Todd Tedeschi testified that Charmoli told him he should get two crowns at the same time to avoid having to repeat anesthesia, even though his teeth weren’t bothering him.
“It seemed excessive, but I didn’t know any better,” Tedeschi said, according to the outlet. “He was the professional. I just trusted him.”