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News

Dental Office Manager In Region Admits To Role In Medicare Fraud Scheme

Dentist's chair
Dentist's chair Photo Credit: Photo by Michael Browning on Unsplash

A Massachusetts woman has pleaded guilty to her participation in a scheme to defraud the Massachusetts Medicaid program commonly known as MassHealth.

Robin Cronin, age 58, of Worcester, pleaded guilty to one count of conspiracy to commit health care fraud and one count of health care fraud, according to the US Attorney's Office.

In January 2020, Cronin was indicted along with Dr. Anthony DiStefano and Dr. Scott Cale, dentists practicing in Worcester, for their roles in the Medicare fraud scheme.

According to the indictment, from 2014 to 2018, the dental services that DiStefano personally delivered were billed to MassHealth using Cale’s provider identification credentials. 

The purpose of this arrangement was to deceive MassHealth into paying for dental services that were not reimbursable as DiStefano had previously been terminated from the MassHealth provider program over concerns regarding the quality of care he provided to patients. 

Cale then allegedly paid DiStefano a share of the money that MassHealth paid Cale. 

Cronin, DiStefano’s office manager, was aware of the arrangement and personally billed MassHealth for services that were not reimbursable, knowing that the claims were false, the US Attorney's Office said. 

DiStefano and Cale have pleaded not guilty and are considered innocent until proven guilty.

The charges of health care fraud and conspiracy to commit health care fraud provide for a sentence of up to 10 years in prison, three years of supervised release, and a fine of up to $250,000. 

She is scheduled to be sentenced early next year. 

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