FWA-Worcester dental office manager sentenced for Medicaid fraud

MM Curator summary

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[MM Curator Summary]: Robin Cronin stole an un-disclosed amount by helping other providers to bill for services under their IDs- since they had been banned from MA Medicaid years before.

 
 

 
 

Clipped from: https://www.sentinelandenterprise.com/2023/08/17/worcester-dental-office-manager-sentenced-for-medicaid-fraud/

The 61-year-old received two years probation

 
 

Worcester dental office manager Robin Cronin, 61, was sentenced by U.S. Senior District Court Judge Timothy S. Hillman to two years’ probation. In September 2020, Cronin pled guilty to one count of conspiracy to commit health care fraud and one count of health care fraud. (AP Photo/Patrick Semansky)

BOSTON — A Worcester woman was sentenced today for her participation in a scheme to defraud the Massachusetts Medicaid program, commonly known as MassHealth.

Robin Cronin, 61, was sentenced by U.S. Senior District Court Judge Timothy S. Hillman to two years’ probation. In September 2020, Cronin pled guilty to one count of conspiracy to commit health care fraud and one count of health care fraud.

Cronin was indicted by a grand jury and arrested in January 2020 along with co-conspirators Dr. Anthony DiStefano III and Dr. Scott Cale, dentists practicing in Worcester.

DiStefano was barred from participating in the MassHealth insurance program because of concerns regarding the substandard and dangerous dental care he delivered to patients. In order to circumvent his exclusion from the MassHealth provider network, DiStefano recruited another co-defendant, 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. 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.  The purpose of this arrangement was to deceive MassHealth into paying for dental services that were not reimbursable since DiStefano had already been barred from the MassHealth provider program.

As a result of this scheme, multiple MassHealth patients were harmed and received dangerously poor care from DiStefano.

Cale also pleaded guilty to his role in the conspiracy and, on Aug. 10. 2023, was sentenced to 18 months in prison and one year of supervised release. Charges against DiStefano were dismissed.

The announcement of the sentencing was made by Acting U.S. Attorney Joshua S. Levy, state Attorney General Andrea Joy Campbell, and U.S. Department of Health and Human Services Special Agent in Charge Roberto Coviello, along with the Office of the Inspector General, Office of Investigations.

Assistant U.S. Attorneys Evan Panich and Chris Looney of the Health Care Fraud Unit and Special Assistant U.S. Attorney Kevin Lownds prosecuted the case.