Worcester dental office manager pleads guilty to role in Medicare fraud scheme

 

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Date: September 21, 2021

Contact:  newsroom@ci.irs.gov 

Boston — A Worcester woman pleaded guilty today to her participation in a scheme to defraud the Massachusetts Medicaid program, commonly known as MassHealth.

Robin Cronin of Worcester, pleaded guilty to one count of conspiracy to commit health care fraud and one count of health care fraud. U.S. District Court Judge Timothy S. Hillman scheduled sentencing for Jan. 21, 2022.

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

According to the indictment, from 2014 to 2018, 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.

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. Sentences are imposed by a federal district court judge based upon the U.S. Sentencing Guidelines and other statutory factors.

Acting United States Attorney Nathaniel R. Mendell; Massachusetts Attorney General Maura Healey; Joleen D. Simpson, Special Agent in Charge of the Internal Revenue Service's Criminal Investigations in Boston; and Phillip Coyne, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of the Inspector General, Office of Investigations made the announcement today. Assistant U.S. Attorneys Evan Panich and Chris Looney of Mendell's Office, as well as Special Assistant U.S. Attorney Kevin Lownds, detailed from Healey's Office, are prosecuting the case.

The details contained in the indictment are allegations. The remaining defendants are presumed innocent unless and until proven guilty beyond a reasonable doubt in a court of law.