A federal grand jury in Boston has indicted a Worcester dentist, a Chelmsford dentist, and a Worcester office manager for their participation in a scheme to defraud the Massachusetts Medicaid program, commonly known as MassHealth. Dr. Anthony DiStefano III, 70, of Worcester, was indicted on one count of conspiracy to commit health care fraud, one count of health care fraud, two counts of aggravated identity theft and one count of tax evasion. Dr. Scott Cale, 65, of Chelmsford, and Robin Cronin, 58, of Worcester, were each indicted on one count of conspiracy to commit healthcare fraud and one count of healthcare fraud. According to the indictment, in 2005, MassHealth excluded DiStefano, a dentist practicing in Worcester, from participation in the MassHealth program. DiStefano twice sought readmission into MassHealth’s provider network, but was denied both times in light of significant concerns regarding the quality of dental care he delivered to patients. In order to circumvent his exclusion, DiStefano recruited another dentist, Cale, to join his practice. From 2014 to 2018, dental services that DiStefano personally delivered were billed to MassHealth using Cale’s provider identification credentials. Cale then paid DiStefano a share of the money that MassHealth paid Cale. The purpose of this arrangement was to deceive MassHealth into paying for dental services that were not reimbursable (because MassHealth had terminated DiStefano from the MassHealth program). 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.
