TRENTON — The Office of the State Comptroller (OSC) will seek recoveries from a dental practice that allegedly forged Medicaid reimbursement documents to conceal that its owner, who was no longer physically able to treat patients, had been replaced with a dentist who was debarred from the Medicaid program.
According to a Notice of Claim filed today, Anicia Cruz-Sledge assumed control of the Gentle Dental Group in East Orange in 2007 after her husband, the owner and primary dentist for the practice, suffered a medical condition that left him incapacitated and no longer able to treat patients.
The investigation by OSC’s Medicaid Fraud Division found that Gentle Dental submitted Medicaid reimbursement claims using Dr. Edward Sledge’s individual Medicaid provider number, signatures purporting to be from Dr. Sledge and certification forms stating that Dr. Sledge had performed the medical services in question. Those services were allegedly provided, however, by Dr. Carl McGloster, who had been hired by Anicia Cruz-Sledge to treat patients at the dental practice even though he was debarred from participating in the Medicaid program.
According to the Notice of Claim, Ms. Cruz-Sledge admitted to OSC investigators that she signed her husband’s name on the reimbursement claim forms submitted to the state even though her husband did not treat the patients. OSC investigators also determined that Ms. Cruz-Sledge continued to order new prescription pads under her husband’s name long after he became incapacitated.
According to the Notice of Claim, McGloster issued 290 prescriptions to Medicaid patients utilizing Dr. Sledge’s prescription pad, including 63 prescriptions for controlled 2 dangerous substances. McGloster was not legally authorized to treat Medicaid patients or apply for Medicaid reimbursements for any such treatment.
OSC investigators also identified several instances in which prescriptions were telephoned into a pharmacy by an individual identifying herself as “Annie.” In those instances, the individual verbally identified the prescriber as Dr. Sledge and provided Dr. Sledge’s DEA registration number to the pharmacy even though the actual prescriber was Dr. McGloster.
Ms. Cruz-Sledge also admitted to performing dental assistant and hygienist services without possessing the required state licenses, according to OSC. Two other dentists who were not approved to provide services to Gentle Dental Medicaid patients were also allegedly hired by Cruz-Sledge and provided such services.
All Medicaid payments to Gentle Dental were suspended by OSC in March 2012. OSC is seeking from the company more than $1.3 million for improperly reimbursed claims, damages and penalties.
In a separate Notice of Claim filed today, OSC also is seeking more than $510,000 from McGloster personally for improper Medicaid claims. According to the Notice of Claim, McGloster wrote a total of 427 prescriptions to Medicaid patients while excluded from the Medicaid program.
“It is particularly brazen for someone who already has been banned from the Medicaid program to try to get around that ban by impersonating a doctor who has become medically incapacitated,” State Comptroller Matthew Boxer said.
The statements in OSC’s notices of claim are only allegations. The providers have the right to contest OSC’s claims and seek a hearing before the Office of Administrative Law.
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