Antoine Skaff has pleaded guilty to West Virginia Medicaid fraud and will pay $2.2 million in treble (triple) damages. A dentist based in Charleston, WV, Skaff has admitted he defrauded West Virginia Medicaid and other Medicaid-managed state organizations of over $700,000.
In his guilty plea, Skaff acknowledged that he had submitted false claims to Medicaid and Medicaid-managed Care Organizations for procedures that were never performed. For at least five years, Skaff used upcoding (billing for pricier procedures) and double billing to defraud Medicaid for his personal gain.
The dentist admitted that he routinely billed simple tooth extractions, which normally cost $80, as more complex extractions of impacted teeth, which cost $172. According to his own admissions, Skaff upcoded over 7,490 extractions, which resulted in $1.3 million in billings to Medicaid, when they should have only cost the government program about $600,000. In terms of double billing, Skaff admitted he received about $57,000 in reimbursements, after billing West Virginia Medicaid twice for the same tooth extractions.
The defendant is still awaiting sentencing, which will take place in November. Besides paying about $738,000 in restitution and $2.2 million in treble damages, Skaff could face a maximum of 10 years in prison. Additionally, he will be unable to receive Medicaid or Medicare reimbursements for any dental procedures for the next 13 years. Although Skaff hasn't been banned from practicing, the measure will certainly limit his ability to run a profitable dental office.
Back in April, Skaff´s office on MacCorkle Avenue (Kanawha) was raided by FBI agents. Law enforcement interrupted Skaff Family Dentistry’s usual business, and agents were seen going in and out of the building during a whole morning and afternoon, when they presumably obtained records that substantiated the Department of Justice’s case against the proprietor.
According to U.S. Attorney Carol Casto, the case is a positive example of the government's fight against Medicaid fraud. “Through the civil, criminal and administrative processes brought to bear, the Medicaid program will be made whole, Dr. Skaff will be punished, and we will protect federal health care dollars in the future by securing his exclusion from these programs,” she has commented.
The guilty plea and monetary recovery are certainly a success for the Medicaid Fraud Control Unit. The head of West Virginia’s Department of Health and Human Resources highlighted the importance of the collaboration between federal and state agencies to end healthcare fraud.
If you are an employee of a dental office or other healthcare provider and have inside information about cheating West Virginia Medicaid or Medicare, you may be eligible for a reward. Stop fraud and check your eligibility. Email Us