Dentist charged with health care fraud sentenced to 4 1/2 years in prison

Charmoli purposefully damaged patients’ teeth to get insurance coverage

Last updated on July 21st, 2022 at 11:35 am

Scott Charmoli, a Grafton resident who worked as a dentist at a practice in the Washington County village of Jackson has been sentenced to 4 1/2 years in prison for purposefully damaging the teeth of several patients during hundreds of crown procedures. He was also ordered to pay over $1 million in forfeiture.

Charmoli previously practiced at Jackson Family Dentistry. He worked in the community for over 28 years. He was the sole owner and dentist working at the business. Charmoli was first indicted on charges of health care fraud and false statements relating to health care matters in December 2020.

In 2015, Charmoli began his scheme to defraud dental insurance companies into paying for unnecessary crown procedures. He “aggressively” sold crowns to patients and then intentionally broke their teeth with his drill to have insurance companies pay for the crowns, according to a press release from the U.S. Department of Justice.

Evidence at trial showed that Charmoli performed far more crowns than most dentists in Wisconsin, ranking in, or above, the 95th percentile of crowns performed each year from 2016 to 2019.

The evidence also showed that Charmoli billed over $4.2 million for crown procedures between 2016 and 2019 and that he performed more than 700 crowns each year from 2015 to 2019. In 2015 and 2016, Charmoli performed over 1,000 crown procedures.

In addition to submitting x-rays to insurance companies of damage he had caused, Charmoli made false statements to dental insurers when they denied initial claims for crown coverage.

“Mr. Charmoli abused a position of trust and lied to his patients and their insurers simply to line his own pockets,” said Richard Frohling, United States attorney for the Eastern District of Wisconsin. “Despite already having many advantages in life, Mr. Charmoli simply wanted more, and he was willing to harm his patients physically, emotionally, and financially to fund his lifestyle. I commend the hard work of the FBI agents and the trial team in pursuing justice for the victims in this case.”

As part of his sentence, Charmoli has already been ordered to pay $1,043,229.31 in forfeiture. He will also be responsible for reimbursing insurance companies and patients who received fraudulent crowns for their out-of-pocket expenses. U.S. District Court Judge Lynn Adelman will determine the final amount of restitution owed within 90 days. Charmoli is also the subject of several malpractice lawsuits brought by former patients.

“Health care fraud remains a top priority for the FBI due to the negative effects it has on our community,” said Michael E. Hensle, special agent in charge of the FBI’s Milwaukee field office. “Not only do health care fraud schemes like this cost the U.S. taxpayers through increased health insurance premiums and greater out-of-pocket expenses, they also cause unnecessary pain and suffering to those who seek the assistance of trusted health care professionals.”

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Ashley covers startups, technology and manufacturing for BizTimes. She was previously the managing editor of the News Graphic and Washington County Daily News. In past reporting roles, covering education at The Waukesha Freeman, she received several WNA awards. She is a UWM graduate. In her free time, Ashley enjoys watching independent films, tackling a new recipe in the kitchen and reading a good book.

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