Southington Dentist Is Charged with Medicaid Fraud

A Southington dentist was arrested Tuesday and charged with defrauding Medicaid by billing the government health care program for more expensive procedures than he actually did or procedures that were not performed at all.

Thomas L. Derienzo, 58, of Bucks Hill Road, Southbury, was charged with one count each of first-degree larceny by defrauding a public community, second-degree vendor fraud and insurance fraud, according to the Connecticut Department of Justice.

According to the arrest warrant affidavit, between 2010 and 2014 DeRienzo submitted claims for payment by Medicaid for dental services he purportedly had rendered as owner of Plantsville Family Dental in the Plantsville section of Southington.

Investigation disclosed that in 282 instances the claimed services were either not rendered at all or were “upcoded,” which means they were assigned an incorrect billing code in order to increase the allowable payment.

In another 67 instances the claimed services were not documented in medical records, and in another 193 instances the claimed services appeared to dental experts who reviewed them to be medically unnecessary, the warrant states. The total value of these false claims is $7,213.92.

DeRienzo was released on a $10,000 bond and is scheduled to appear in Hartford Superior Court, on Thursday.

First-degree larceny by defrauding a public community is a class B felony punishable by up to 20 years in prison. Vendor Fraud in the Second Degree is a class C felony punishable by up to 10 years in prison. Insurance Fraud is a class D felony punishable by up to 5 years in prison.

The case will be prosecuted by the Medicaid Fraud Control Unit in the Office of the Chief State’s Attorney. The unit is grateful for the assistance it received in this investigation from the U.S. Department of Health and Human Services Office of Inspector General and the Connecticut Attorney General’s Office.