By: Christopher A. Parrella, Esq., CPC, CHC, CPCO
Parrella Health Law, Boston, Ma.
A Health Care Defense and Compliance Firm

The Commonwealth’s Attorney General Andrea Joy Campbell has taken decisive action against healthcare fraud within Massachusetts, underscoring the state’s commitment to maintaining the integrity of its healthcare programs and safeguarding taxpayer resources. The recent indictments against Dr. Marcus Swann and his Falmouth-based dental practice, Direct Pay Dental, highlight the seriousness with which the state addresses allegations of Medicaid fraud.

Dr. Swann and his practice face charges related to the submission of nearly $200,000 in false claims to MassHealth. These claims were for dental services purportedly not provided or services that, while claimed, were not performed by a licensed dentist as required by law. Specifically, the charges include four counts each of Medicaid False Claims and Larceny Over $1,200, stemming from incidents dating from May 10, 2017, through December 31, 2020.

The allegations suggest that Dr. Swann and Direct Pay Dental exploited the MassHealth program by billing for procedures performed by dental hygienists or assistants, such as patient exams and crown placements, that should legally be performed by a dentist. Additionally, the practice is accused of billing for dental services that were not provided to patients, violating the trust and provisions of the MassHealth program.

Attorney General Campbell’s statement emphasizes the dedication of her office to upholding the principles of quality healthcare and the appropriate use of public funds. She articulated a strong stance on holding accountable those who undermine the MassHealth system, thereby protecting not only taxpayer resources but also ensuring the provision of legitimate and necessary healthcare services to Massachusetts residents.

This case serves as a critical reminder of the legal and ethical obligations healthcare providers have to their patients and to the healthcare system at large. Fraudulent billing practices not only deplete valuable resources from healthcare programs but also compromise the quality of care that patients receive.

At Parrella Health Law, we understand the complexities and challenges healthcare providers face in navigating the regulatory and compliance landscape of Medicaid and other healthcare programs. Healthcare fraud cases like this one underscore the importance of rigorous compliance programs and internal controls to prevent fraudulent practices. Parrella Health Law is here to assist healthcare providers in implementing effective compliance strategies, conducting internal audits, and providing training to ensure adherence to all legal and regulatory requirements. For healthcare providers seeking guidance on compliance matters or facing legal challenges, Parrella Health Law offers the expertise and support needed to navigate these complex issues successfully. Please call us at 857-328-0382 or send an email to info@parrellahealthlaw.com.

Christopher Parrella, ESQ, CPC, CHC, CPCO, is the founding partner of Parrella Health Law in Boston, Mass. The firm focuses exclusively on healthcare defense and compliance matters. Chris also travels the country on behalf of a wide range of healthcare organizations, lecturing on a variety of health care enforcement and compliance topics. Chris is one of a handful of health care attorney’s that are also Certified Professional Coders (CPC) and is a member of the AAPC’s National Legal Advisory Board and Ethics Committee.  He is also a Certified Professional Compliance Officer (CPCO) and Certified in Health Care Compliance (CHC.)