MIAMI (CBSMiami)– A dental professional in South Florida deals with scams charges for billing clients for work currently covered under Medicaid.
Dr. Fadi Yousef Qablawi, 39, targeted senior clients with Medicaid by informing them their treatment would need to be paid out-of-pocket, regardless of understanding that Medicaid would, in fact, cover the work, according to the Medicaid Fraud Control Unit under the Office of Attorney General in Florida.
Dentures, for instance, need just a 5 percent co-pay from the insured individual aged 21 and older, per the Florida Medicaid Dental Services Coverage and Limitations Handbook.
Detectives stated Qablawi would rather charge the patient the complete expense for the treatment, approximately in between $300 and $600, and then expense Medicaid for a repayment.
The examination originated from a grievance in November 2013 after a lady was informed she would have to pay $400 for a set of upper and lower dentures. She made the payment to Dr. Qablawi’s workplace and after that on her follow-up see, according to authorities, was informed she would have to pay an extra $200 because the rate was, in fact, $300 for each set of dentures, amounting to $600. The lady consulted Medicaid, who notified her that she just had to pay the 5 percent co-pay and not the total. When she grumbled to Dr. Qablawi, she was informed to take her business in other places.
Additional examination exposed 20 victims who specified they were charged a co-payment prior to the shipment of their dentures.
Findings suggested Qablawi billed Medicaid for $16,138 and was compensated $13,737. He likewise billed his clients another $10,260.
Qablawi was registered as a Medicaid company in 2006 and ran from 2 oral workplaces, “Mecca Dental” situated at 27501 S. Dixie Hwy, Ste 300 in Homestead, and “Madina Dental” at 888 N.E. 126th Street, Ste 203 in North Miami.
Qablawi was charged with Medicaid Fraud, Organized Fraud, and Trafficking Medicaid Property.