Dentist Pleads Guilty to $783,000 Overbilling Scheme
RICHMOND, Va. – A Glen Allen dentist pleaded guilty today to a four-year healthcare fraud scheme in which she fraudulently obtained more than $783,000 from Medicaid and four dental insurers.
According to court documents, Maryam E. Zarei, 47, was the owner and operator of Atlee Station Family Dentistry, a general dentistry practice located in Mechanicsville. Zarei controlled the submission of claims to insurance companies for reimbursement, and from 2013 to 2016, defrauded Medicaid, Delta Dental, AETNA, Met Life, and U.S. Healthcare of approximately $783,000. The scheme involved three parts: 1) Zarei fraudulently billed Medicaid and the insurers for services never rendered, including a variety of purported services when Zarei was in fact out of the country; 2) Zarei billed the insurers for services using inappropriate billing codes that resulted in higher bills than were justified by the actual service performed, includeding, for example, upcoding of preventive resins to costlier resin-based composites, and upcoding routine extractions to surgical extractions; and 3) Zarei billed insurance companies for services performed after termination of the patients’ insurance coverage and then backdated the claims documents to make it appear that the services had occurred when the insurance policies were in effect.
Zarei pleaded guilty to one count of healthcare fraud and faces a maximum penalty of 10 years in prison when sentenced on March 16, 2018. Actual sentences for federal crimes are typically less than the maximum penalties. A federal district court judge will determine any sentence after taking into account the U.S. Sentencing Guidelines and other statutory factors.
Dana J. Boente, U.S. Attorney for the Eastern District of Virginia, Mark R. Herring, Attorney General of Virginia, and Adam Lee, Special Agent in Charge of the FBI’s Richmond Division, made the announcement after U.S. District Judge Henry E. Hudson accepted the plea. Assistant U.S. Attorney David T. Maguire and Special Assistant U.S. Attorney David W. Tooker are prosecuting the case.
A copy of this press release is located on the website of the U.S. Attorney’s Office for the Eastern District of Virginia. Related court documents and information is located on the website of the District Court for the Eastern District of Virginia or on PACER by searching for Case No. 3:17-cr-157.