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MADISON - Attorney General J.B. Van Hollen announced today that a Hudson dentist, Anthony R. Sanchez, has been convicted of three counts of theft related to his prohibited provider charges of Medicaid recipients. Sanchez appeared in front of St. Croix Circuit Court Judge Eric Lundell today where he entered pleas of no contest according to the terms of an agreement and was convicted. Sanchez prepaid restitution for six identified victims in the amount of $5,638.20 and was fined $10,500.00 for the three counts. Sanchez also agreed not to contest placement on the U.S. Department of Health & Human Services, Office of Inspector General, provider exclusion list.
Wisconsin law prohibits providers in the Medicaid system from imposing direct charges on a recipient for services that are covered by the program. "My office won't stand by while our neediest citizens are being exploited for profit," stated Van Hollen. "We work hard to prevent Medicaid fraud to protect taxpayers and so that money will be there to help those who need it most."
According to the Department of Justice's criminal complaint Sanchez, 35, 243 W. Canyon Drive, Hudson, owns Smi:)e Dental at 131 Carmichael Road in Hudson. Between April 2005 and March 2006, Sanchez advised five patients that they required root canals and that Medicaid did not cover the service. The patients were made to pay between $400 and $775 to cover the procedures. Another patient was charged $4,000 due to needing bridge work in addition to the root canal. Sanchez was aware the Medicaid Program does reimburse the cost of root canals and bridge work but chose not to inform the patients of this or told them that those were not covered and instead required them to pay.
During this same time period Sanchez instituted a policy requiring Medicaid recipients to pay $50 to make an appointment. If patients kept the appointment they were not charged a co-pay but were not reimbursed the balance of the $50. That is also prohibited by Wisconsin law.
The State of Wisconsin was represented by Assistant Attorney General Thomas Storm.