California Dentist Sentenced for Teamster Benefit Ripoff

teamsters-logoDavid Lewis enriched himself in ways that neither the dentistry profession nor Teamster members recognized – or liked.  Several months ago, he learned the high price of his actions.  On May 5, Lewis, a Sacramento-based dentist, was sentenced in U.S. District Court for the Eastern District of California to three years and 10 months in prison, and fined $75,000, for skimming at least $1 million from a union-sponsored health plan covering employees of United Parcel Service.  He had pleaded guilty in January after being indicted on 18 counts in February 2014.  The actions follow an investigation by the U.S. Labor Department’s Office of Inspector General and Employee Benefits Security Administration, plus the California Attorney General’s Office and the state’s Dental Board.

Union Corruption Update discussed this case several months ago.  According to federal prosecutors, Lewis, now in his early 60s, back in late 2008 or early 2009 developed a set of schemes to fleece the Northern California Teamsters Security Fund.  The dental plan, designed by Delta Health Systems, was generous to a fault, featuring 100 percent coverage with no annual limit.  Lewis often billed the fund for procedures not performed.  In other cases, he conducted unneeded procedures on patients’ healthy teeth, including root canals and temporary fillings, and then billed Delta for reimbursements.  Additionally, he told his assistants to take X-rays and send them to Delta as evidence of “tooth decay” that would justify further work.  The scams totaled at least $1 million.  Worse, some of Dr. Lewis’ “treatments” resulted in injury and disfigurement.

A former insurance claims manager for Lewis’ office, Nichol Ramirez aka Nichol Lomack, exposed the scams.  In December 2010 she told the California Dental Board that her employer was ripping off the Teamster health plan.  In the process, she acknowledged her participation in the offenses.  Whether motivated by guilt, duty or fear of a prison sentence, her admission led to separate probes by the state dental board and the U.S. Labor Department.  Both audits concluded that Lewis had defrauded the plan.  A subsequent Justice Department investigation led to Lewis’ 2014 indictment.  By this January, with Lomack already having pleaded guilty, Lewis read the tea leaves and did likewise.  At sentencing, Abel Salinas, Special Agent in Charge of the Los Angeles Regional Office of the U.S. Labor Department’s Office of Inspector General’s Racketeering and Fraud Office, put it this way:  “Today’s sentencing demonstrates that those who commit health care fraud will be held criminally accountable.  We will continue to work with our law enforcement partners to safeguard the health benefits of union workers from medical providers seeking self-enrichment.”