David M. Lewis, Health Care Fraud, California 2016

SACRAMENTO, Calif. — A Sacramento dentist was sentenced to over three years in prison for billing for unnecessary or unperformed dental work.

David M. Lewis, 62, of Sacramento, was sentenced by United States District Judge Morrison C. England Jr. to three years and 10 months in prison and a $75,000 fine for health care fraud, Acting United States Attorney Phillip A. Talbert announced.

According to court documents, beginning approximately in late 2008, Lewis, a dentist practicing in Sacramento, began targeting United Parcel Service employees for dental treatment because their health care plan under the Northern California General Teamsters Security Fund provided 100 percent coverage without any annual limits.

Lewis offered cash and other incentives to UPS patients for receiving dental treatment or for recruiting other UPS employees to receive such treatment.

The UPS health care plan was administered by Delta Health Systems. In some instances, Lewis caused claims to be submitted to Delta that falsely billed the plan for work that was never performed. In many other instances, Lewis performed unnecessary dental work on UPS employees, including root canals, and claims were submitted to Delta for payment for these unnecessary services.

Lewis created false narratives for dental work that was not performed or created false statements about purported pre-existing dental conditions to justify the work performed. In some instances, Lewis drilled into teeth to install temporary filings and instructed his assistants to take X-rays of the temporary filings. Lewis then submitted claims to Delta with X-rays of the temporary fillings, falsely claiming that the X-rays depicted tooth decay justifying further restorative procedures.

“This defendant went well beyond the lies one normally finds at the root of a fraud scheme,” said Acting U.S. Attorney Talbert. “He not only plundered funds meant to provide essential services, he inflicted pain and suffering on his patients through the performance of unnecessary medical procedures, all in the name of additional profit. We are gratified by today’s sentence, and thankful for the critical work done by our partners in the Department of Labor and the State of California.”

A restitution hearing is set for June 23, 2016, and Lewis is scheduled to self-surrender to begin serving his sentence on July 14, 2016.

Mandatory Facts:

1. Defendant: David M. Lewis

2. Exact Criminal Charges: Health care fraud

3. City and State: Sacramento, California

4. Exact Date: Not specified in the original press release.

5. Sentence or Outcome: Three years and 10 months in prison and a $75,000 fine

6. Dollar Amounts: $75,000 fine

Source: https://www.justice.gov/usao-edca/pr/sacramento-dentist-sentenced-over-3-years-prison-billing-unnecessary-or-unperformed