Medicare Fraud Case Judgment Tops $18 Million

PHILADELPHIA —  A dentist who illegally charged the government for unauthorized cancer screenings on elderly patients must pay nearly $19 million in the largest judgment ever in a Medicare fraud case.

John Lorenzo, 56, of Bala Cynwyd, outside Philadelphia, was ordered to reimburse the federal government $18.8 million for filing 3,683 false claims for reimbursement under Medicare, according to a judgment filed Tuesday.

U.S. District Judge Joseph McGlynn ruled, in a non-jury trial, that Lorenzo illegally billed the federal insurance program for the elderly for dental exams of nursing home patients in Pennsylvania and New Jersey.

Between 1983 and 1988, Lorenzo assigned dentists--most of them recent dental-school graduates employed by a company headed by Lorenzo’s wife, Diana--to screen the patients for oral cancer. In 1986, he began billing Medicare for the exams, even though the patients’ doctors had not ordered the procedures.

Under Medicare guidelines, a patient’s doctor must authorize the exam before it can be performed.

Assistant U.S. Atty. James Sheehan told the Philadelphia Inquirer that his office would wait 10 days. then begin seizing physical assests owned by Lorenzo, including his companies, cars and bank account.

Lorenzo told the Inquirer he was shocked by the judgment.