The Joplin Globe, Joplin, MO

Joplin Metro

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November 13, 2008

Dentist charged with Medicaid fraud

By Jeff Lehr

jlehr@joplinglobe.com

A Joplin dentist was arrested Thursday morning on 13 felony counts of submitting false Medicaid reimbursement claims on pediatric patients.

Samuel A. Miller, 43, was arrested at 6:49 a.m. at the intersection of Iron Gates Road and 27th Street and was taken to the Joplin City Jail, where he remained by late afternoon with no bond set. In the meantime, a search warrant was served at his office at 2530 S. Maiden Lane, and records were seized.

The state attorney general’s office said in a news release later in the day that 13 felony counts were being filed against Miller through the Jasper County prosecutor’s office.

According to the news release, a probable-cause affidavit signed by an investigator in the attorney general’s Medicaid fraud-control unit alleges that the dentist billed the government program for X-rays, root canals, composite restorations and amalgam restorations that were never performed.

The attorney general’s office said the allegations cover a period from November 2005 through June 2006.

The attorney general’s office alleges two types of fraud committed by Miller: “upcoding” of services and “bundling” of claims.

Upcoding is defined as claims for more complicated and expensive procedures than were actually performed. Bundling concerns separate claims submitted for individual steps in a multistep procedure that should be submitted as a single procedure.

Both forms of alleged fraud were charged as making a false statement to receive a health-care payment, which is a Class D felony in Missouri punishable by up to four years in prison and a $5,000 fine.

The news release did not provide a dollar amount for the extent of the alleged fraud. Convictions for Medicaid fraud can result in court orders of restitution for the amount unlawfully reimbursed plus the costs to the state of prosecution.

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