Excluded and Unlicensed New Jersey Dentist Who Assumed Identity of Another Dentist Agrees to Settlement of $1.1 Million and 50-Year Exclusion to Resolve Civil Monetary Penalty Case
Washington, DC – Unlicensed New Jersey dentist Roben Brookhim who assumed identity of another dentist agreed to pay $1.1 million and accept a 50-year exclusion from participating in Federal health care programs as part of a settlement to resolve his administrative liability for presenting false claims to Medicaid, billing for services furnished by an excluded person, and owning and controlling a Medicaid-participating entity while he was excluded, the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) announced today.
“Fifty years is one of the longest exclusion periods ever imposed by our office,” said Gregory E. Demske, Chief Counsel to the HHS Inspector General. “This period of exclusion, coupled with the significant monetary recovery, is an appropriate resolution for an individual who went to such great lengths to defraud a Federal health care program and put patients at risk,” said Demske.
OIG alleged that from November 2005 through October 2012, Brookhim owned, controlled, and managed Associated Dental NP, LLC (ADNP), a New Jersey dental practice with multiple locations, in violation of his exclusion from Federal health care program participation in August 2000.
As part of his fraud scheme, Brookhim assumed the identity of a licensed New Jersey dentist (“Dentist A”), to provide services to ADNP patients. Brookhim assumed Dentist A’s identity because Brookhim had lost his dental license in 2004. Brookhim presented claims for services to various New Jersey Medicaid Managed Care Organizations (MCOs), identifying Dentist A as having providing services. In fact, Dentist A never rendered services to ADNP patients. Brookhim continued to pose as Dentist A and submit claims in his name — even after Dentist A died.
“This case sends a strong warning that individuals who intentionally circumvent exclusion to defraud Federal health care programs face substantial consequences. OIG is committed to protecting program beneficiaries and funds from individuals who violate their exclusions,” said Demske.
Under the Civil Monetary Penalties Law (CMPL), OIG may seek civil money penalties, assessments, and exclusion for causing submission of false or fraudulent claims to Federal health care programs. The CMPL is designed to deter individuals from defrauding those programs, to compensate the programs for damages resulting from such fraud, and to protect their integrity.
Special agents from OIG’s Office of Investigations, New York Regional Office, under the direction of Special Agent in Charge Scott Lambert, investigated this case.
OIG was represented in the investigation and litigation by Senior Attorneys David M. Blank and Michael R. Torrisi, with assistance from Paralegal Mariel Filtz.
|Written by Susen Sawatzki|
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