This is the story of Scott Charmoli, a dentist who intentionally broke customers’ teeth to defraud insurance companies of $4.5 million.
Who is Scott Charmoli?
Scott Charmoli is a 61-year-old Grafton resident who ran Jackson Family Dentistry, a dental practice in Jackson, Wisconsin. He was first licensed in 1986.
How did Scott Charmoli pull off the teeth-breaking scam?
Beginning in 2015, Charmoli started convincing patients on the need for crown procedures. Charmoli intentionally chipped their teeth with his drill so he could crown them. He then took pictures and X-rays of the damaged teeth and sent them to insurance companies. An executive with one of the insurance agencies testified that, on average, Wisconsin dentists installed fewer than 6 crowns per 100 patients. However, Charmoli installed more than 1,600 crowns over a 20-month period. His rate was more than 32 crowns per 100 patients.
During a dental check up, Charmoli showed his patients an X-ray of a healthy tooth but drew their attention to a line or spot on the tooth. He claimed it to be a fracture or decay, and that it needed a crown. “Patients, who believed Charmoli was the expert, accepted his false representations and agreed to the crown procedure,” the indictment stated.
Todd Tedeschi, a former patient, testified that Charmoli convinced him to get two crowns at the same time to avoid repeating anesthesia. Todd’s teeth weren’t bothering him, and he thought Charmoli’s suggestion was “excessive”. Nevertheless, he trusted the professional, not knowing any better, and agreed to the procedure.
What patients didn’t realize is that the teeth-breaking fraudster dentist was going to break their teeth and take an x-ray that would accompany an insurance claim. Since insurance doesn’t generally cover crown procedures fully, the patients had to pay for part of the cost of crown installation. Charmoli made false statements to dental insurers when they denied initial claims for crown coverage.
Charmoli’s teeth-breaking scheme revealed
Charmoli reportedly sold his dental practice in 2019. As the new owners were reviewing the practice’s files, they saw that the crown numbers were unusual. This concurred with testimony from Baily Bayer, a former assistant at Jackson Family Dentistry, who said that the office became extremely busy after it relocated to larger space. Charmoli had hired marketing consultants who urged the office to sell more services.
Bayer said that she noticed significantly tighter scheduling, more procedures, and a smaller staff-to-patients ratio. Although she was new to the practice, it didn’t make sense to her that X-rays would be taken after Charmoli had done some drilling. She added that Charmoli would say he used to work in insurance, and “insurance is going to want to see this.”
Bayer left the job after it became unbearably uncomfortable and stressful, seeing people being forced to take procedures they didn’t need.
According to the indictment, Charmoli received $318,600 out of $745,570 in claims submitted to Delta Dental between Jan. 1, 2016, and June 28, 2018. He also received another $114,294 on claims during the first six months of 2019.
The Federal Bureau of Investigation investigated the case. Assistant U.S. Attorneys Julie F. Stewart and Michael A. Carter prosecuted it. The evidence showed that Charmoli billed over $4.2 million for crown procedures between 2016 and 2019.
Scott Charmoli indicted and convicted
In December 2020, a federal grand jury indicted Charmoli. After a four-day trial in Milwaukee federal court, in March this year, the jury found him guilty on seven counts.
“United States Attorney Richard G. Frohling of the Eastern District of Wisconsin announced that on March 10, 2022, Scott Charmoli (age: 61) of Grafton Wisconsin, a licensed dentist, was convicted of five counts of healthcare fraud and two counts of making false statements related to healthcare matters,” read a news release from the U.S. Attorney’s Office for the Eastern District of Wisconsin.
Charmoli faces up to 20 years in prison. His sentencing is scheduled for June 17. In addition, about 100 former patients of Jackson Family Dentistry have sued him for medical malpractice. Those cases are pending the outcome of the federal prosecution.
Charmoli cannot legally practice dentistry in Wisconsin. His license was suspended starting February 2021 as the state’s Dentistry Examining Board is investigating him.
Call to action
As Baily Bayer, the assistant who left the office after it became uncomfortable, said, dentistry “shouldn’t be a sales pitch. It should be you either need it or you don’t.”
Scott Charmoli; Teeth-breaking fraudster dentist; Jackson Family Dentistry; Wisconsin fraudster dentist