Matthew D. Krueger, United States Attorney for the Eastern District of Wisconsin, announced that on December 15, 2020, a federal grand jury indicted Scott Charmoli (age: 60) of Grafton, Wisconsin, for pursuing a health care fraud scheme that involved purposefully damaging patients’ teeth so that he could bill insurance companies for crown procedures.
According to the indictment, beginning on or about January 1, 2016, Charmoli engaged in a scheme whereby Charmoli falsely advised patients that they needed crowns, purposefully damaged the patients’ teeth during crown procedures, and subsequently submitted x-rays and photographs of the damaged teeth to insurance companies to obtain insurance coverage for the crowns. The indictment asserts that by submitting x-rays and photographs of teeth he had purposefully altered, Charmoli made materially false and fraudulent statements to insurance companies in connection with the delivery of, and payment for, health care benefits. The indictment alleges that Charmoli performed over $2,000,000 worth of crown procedures just between January 1, 2018, and August 7, 2019.
The indictment charges Charmoli with multiple counts of Health Care Fraud and False Statements Relating to Health Care Matters, in violation of 18 U.S.C. § 1347 and 18 U.S.C. § 1035. If convicted, Charmoli faces a maximum sentence of 20 years in prison, up to three years of supervised release, up to a $250,000 fine, and a $100 Special Assessment.
“The Justice Department focuses on prosecuting health care fraud not only to protect health care funds but also to protect patients who entrust their well being to providers,” said United States Attorney Krueger.
The Federal Bureau of Investigation investigated the case, which Assistant United States Attorneys Julie F. Stewart and Michael A. Carter will prosecute.
An indictment is only a charge and not evidence of guilt. The defendant is presumed innocent and is entitled to a fair trial at which the government must prove guilt beyond a reasonable doubt.
The year 2020 marks the 150th anniversary of the Department of Justice. Learn more about the history of our agency at www.Justice.gov/Celebrating150Years.
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For Additional Information Contact: Public Information Officer Kenneth Gales