Scott Charmoli Grafton Wisconsin dentist found guilty of health care fraud for intentionally breaking patients’ teeth to bilk extra profits to the tune of millions over 5 year period.
‘I just trusted him…’ A Wisconsin dentist was last week found guilty of insurance fraud after intentionally damaging patients’ teeth so he could charge them for repairs and in the process reaping millions in profits.
Scott Charmoli, 61, of Grafton, was convicted of five counts of health care fraud and two counts of making a false statement about his patients’ treatment. He will face up to 10 years for each fraud count and a maximum of five years for each of the false statement counts, according to the U.S. Attorney’s Office for the Eastern District of Wisconsin.
Charmoli was found guilty March 10 of giving his patients more crowns for their teeth than 95 per cent of other dentists in Wisconsin from 2016 to 2019. On average, dentists gave out six crowns per 100 patients. Charmoli gave out more than 30 per 100 patients,
He made $1.4million in 2014 by placing 434 crowns, the Washington Post reported. By 2015, he was making $2.5million by fitting more than 1,000 crowns. He eventually ramped up even further from 2016 to 2019 and placed more than 1,600 crowns over a 20-month period from January 1, 2018 to August 7, 2019, the indictment said.
But there’s more.
The former dentist also faces a malpractice lawsuit, brought by nearly 100 patients, in Washington County. The case is pending the federal case sentencing, which is June 17.
Thomas Ogorchock, who represents the patients in the malpractice lawsuit, said it was an ‘interesting, but very sad story’ that made people ‘cringe’.
Nila Robinson is representing Charmoli in the federal case and has not commented on her client’s conviction, but said at his December 2020 arraignment that he was nothing but a ‘hard worker.’
Charmoli sold Jackson Family Dentistry in 2019 to Dr. Pako Major and at that point, Charmoli’s records revealed that his crown placement numbers were exceedingly high.
‘I felt the ethical obligation to report activity that I believed to be suspicious,’ Major wrote on the dentistry’s website. ‘The health and safety of patients is my highest concern as a doctor. As medical professionals, we take an oath to ‘do no harm’ to our patients.’
Pako also assured his patients that they would not receive further care from Charmoli, saying ‘dental care should be built on a foundation of honesty and earned trust.’
Charmoli originally was charged with two more counts of health care fraud after Major reported him, but they later were dropped.
‘He was the professional. I just trusted him.’
The former dentist convinced patients they needed crowns by showing them X-rays of a healthy tooth, but then highlighting a line or spot. He would tell them it indicated a ‘fracture or decay,’ according to the Milwaukee Journal Sentinel, and that they needed crowns. Because patients regarded Charmoli as an ‘expert’, they accepted his ‘false representations and agreed to the crown procedure,’ the indictment read.
Afterward, Charmoli would break the tooth and have the X-rays retaken to show the broken tooth. Those X-rays would be used to file a claim to insurance companies. Crown procedures typically are not covered fully under dental insurance, so patients had significant co-pays.
In addition, he made false statements to insurance companies when the initial crown claims were denied and he would send the broken tooth X-rays.
A former patient Todd Tedeschi also testified that he received a double crown procedure to avoid having repeat anesthesia, even though his teeth weren’t bothering him.
‘It seemed excessive, but I didn’t know any better,’ Tedeschi said. ‘He was the professional. I just trusted him.’
From January 1, 2016 to June 28, 2018, the dentist was paid $318,600 from insurance companies out of the $745,570 he submitted to Delta Dental, the indictment said. From January to June 2019, he would receive another $114,294 from Delta Dental.
He also submitted claims through Optum and United Healthcare. It is unclear how much he made through those insurance companies.
He is alleged to have billed more than $4.2million for crowns between 2016 and 2019.
By the end of 2020, Charmoli had assets worth more than $6.8million, and owned various properties in Wisconsin and Arizona, according to prosecutors.
Charmoli’s dentistry license was revoked in February 2021 due to pending disciplinary actions. He was first licensed in 1986, according to the Washington Post.