Purpose

To determine the extent of implementation of the five recommendations made in our audit report, Suspicious and Fraudulent Medicaid Payments to Affiliated Brooklyn Dentists (Report 2010-S-64).

Background

The Department of Health (Department) administers the State’s Medicaid program, which provides a wide range of health care services, including dental services, to individuals who are economically disadvantaged and/or have special health care needs. Our initial audit identified a dentist, Lawrence Bruckner, whose Medicaid billing pattern was highly unusual. Lawrence Bruckner operated two office locations in Brooklyn, NY. Other dentists who reportedly practiced at the offices included: David Bruckner (Lawrence’s brother); Joseph Bruckner (Lawrence’s son); Arthur Bruckner (Lawrence’s father); Allan Lebovitz; and Robert Thaler. From January 1, 2007 through June 8, 2011, Medicaid paid about $6.9 million for services purportedly performed by the six dentists at the Brooklyn offices.

Our initial audit report, which was issued on April 4, 2013, identified about $2.3 million in highly suspicious and possibly fraudulent Medicaid claims that were submitted by the six affiliated dentists during the period January 1, 2007 through June 8, 2011. Auditors determined that the affiliated dentists created false entries in medical records to support claims, and that it was not possible to perform all of the procedures the dentists billed in relation to the hours their offices were open. Auditors also found that the dentists routinely certified claims for services that were purportedly provided by another affiliated dentist. In addition, the dentists paid staff to recruit Medicaid recipients to their offices. The audit also found questionable sanitary conditions at the two offices used by the dentists.

We referred our findings to the State Attorney General’s Office for further investigation. In August 2012, Lawrence Bruckner pleaded guilty to multiple criminal charges (including felonies) for his conduct. Lawrence Bruckner was sentenced in Kings County Supreme Court and received a state prison term of one to three years. We recommended that the Department determine if additional recoveries should be made, determine whether the dentists should be allowed to participate in the Medicaid program, monitor the dentists’ claims, direct the dentists to cease improper solicitation practices, and inspect the two office locations for unsanitary conditions.

Key Finding

Department officials made progress in addressing the problems we identified in the initial audit report. At the time of our follow-up review, Lawrence Bruckner paid restitution of $681,336 to the State. Additionally, Lawrence Bruckner and three other dentists were removed from the Medicaid program and the remaining two dentists were prohibited from receiving Medicaid payments. Of the initial report’s five audit recommendations, three were implemented and two were partially implemented.

Key Recommendation

Officials are given 30 days after the issuance of the follow-up report to provide information on any actions that are planned to address the unresolved issues discussed in this report.

Other Related Audit/Report of Interest

Department of Health: Suspicious and Fraudulent Medicaid Payments to Affiliated Brooklyn Dentists (2010-S-64)