Fraud

A Marshfield woman who was co-owner of three Missouri dental clinics, including one in Mtn. Grove, has been sentenced in federal court for health care and payroll tax fraud schemes and theft of public money to the tune of over $1 million.   

Pamela M. Van Drie, 59, and her husband Lorin G. Van Drie, 60, were convicted of 40 counts on Feb. 20. The two were the owners of All About Smiles, a Springfield-based company that provided dental services at clinics in Springfield, Mtn. Grove and Bolivar, all of which were closed by November 2015.

They also owned the company that managed the staff for the clinics, P Family Management Company. Pamela Van Drie was sentenced to four years and nine months in federal prison and ordered to pay $1,139,794 in restitution.

Lorin Van Drie could get as many as 10 years in prison for theft of unemployment benefits and five years on each additional conviction, court officials said. His sentencing hearing has not yet been scheduled.   

Fraud schemes that lasted about five years, from October 2010 to August 2015, involved Pamela Van Drie and Dr. James R. Dye, a dentist at the clinics, billing Medicaid for speech aid prosthetics that were not provided to beneficiaries, and billing Medicaid for dentures and other dental services for beneficiaries who weren’t eligible to receive the services because they weren’t medically necessary.

Specifically, Van Drie and Dye purchased orthodontic appliances meant to straighten teeth without braces for about $50 each and billed them to Medicaid for about $695 each as a speech aid prosthesis knowing the appliances should have been billed as orthodontic services and that Medicaid did not cover the appliances unless the program’s requirements were met.  

Those requirements include a review by a dentist/orthodontist employed by Medicaid and precertification. The devices were billed as a speech aid prosthesis in order to bypass the precertification requirement. The Medicaid payments related to that scheme amounted to about $165,700 for about 241 claims.

In another scheme, Van Drie and Dye provided dentures and other dental services to adults who didn’t qualify for Medicaid reimbursement, and submitted claims knowing Medicaid requirements weren’t met.

Van Drie submitted and received $720,048 on claims for dentures and other dental services that lacked the required written referral from a physician.

Dye pleaded guilty in 2016 to health care fraud in a separate but related case. His license was suspended by the Missouri Dental Board due to substandard care at Van Drie’s clinics.

In addition, Van Drie and her husband failed to submit payroll taxes to the IRS from January 2013 to January 2015 totaling $194,751. Pamela Van Drie also reportedly received $3,520 in unemployment benefits she was not entitled to receive because she was working full-time at All About Smiles, from June 2012 through January 2013, by falsifying documents submitted to the Missouri Department of Employment Security.

Lorin Van Drie was found guilty of 18 counts of failure to pay over employment tax and one count of theft of public money related to $11,840 in unemployment benefits claimed while he was working at his own construction company and doing maintenance work at All About Smiles.

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