A woman in Marshfield, Missouri, has been sentenced in federal court for multiple fraud schemes totaling more than $1 million that involved Medicaid payments to her dental clinics, failing to pay over payroll taxes, and collected unemployment benefits she wasn’t entitled to receive.
US District Judge M. Douglas Harpool sentenced Pamela M. Van Drie on October 9 to four years and nine months in federal prison without parole. The court also ordered Van Drie to pay $1.139,794 in restitution. Van Drie and her husband, Lorin G. Van Drie, were convicted on February 20, 2019, of all 40 counts in the federal indictment.
The Van Dries owned All About Smiles, which provided dental services in Missouri until its Bolivar clinic closed in March 2014, its Mountain Grove clinic closed in October 2014, and its Springfield clinic closed in November 2015. They also owned PL Family Management Company, which managed the staff for those clinics.
Pamela Van Drie participated in a conspiracy to commit healthcare fraud from October 6, 2010, to August 19, 2015, consisting of two fraud schemes. She conspired with Dr. James R. Dye, a dentist at the clinics, to fraudulently bill Medicaid for speech aid prosthetics they did not provide to Medicaid beneficiaries. They also conspired to bill Medicaid for dentures and other dental services for beneficiaries who were ineligible to receive such services because they were not medically necessary.
In the first scheme, Pamela Van Drie and Dye purchased Ortho-Tain orthodontic appliances, which are designed to straighten teeth without braces, for about $50 each, provided them to Medicaid pediatric beneficiaries, and billed each appliance to Medicaid as a speech aid prosthesis for approximately $695.
Van Drie and Dye knew the Ortho-Tain appliances should have been billed to Medicaid as orthodontic services. They also knew that Medicaid did not cover orthodontic services unless the Medicaid program’s requirements were met and they received precertification, which required review by a dentist or orthodontist employed by Medicaid. They billed the Ortho-Tain appliances as speech aid prostheses to bypass the precertification requirement.
Between October 6, 2010, and August 19, 2015, Van Drie submitted and received payment for approximately 241 claims submitted for speech aid prostheses. On each claim, All About Smiles or its predecessor company was paid between $675 and $695 for an approximate total amount of $165,700.
In the second scheme, Van Drie and Dye arranged for All About Smiles to provide dentures and other dental services to adults who did not qualify for Medicaid reimbursement. They submitted claims to Medicaid for those dentures and other dental services, knowing that Medicaid’s requirements were not met. Through All About Smiles, Van Drie submitted and received $720,048 on numerous claims for dentures and other dental services that lacked the required written referral from a physician.
Dye pleaded guilty on February 11, 2016, to healthcare fraud in a separate but related case. The Missouri Dental Board suspended his license due to his substandard care for patients at the Van Dries’ clinics.
Pamela and Lorin Van Drie participated in a conspiracy to defraud the government by failing to pay over to the IRS payroll taxes from January 31, 2013, to January 31, 2015. Although payroll taxes were withheld from the paychecks of employees at All About Smiles and PL Family Management, the Van Dries failed to pay over to the IRS about $194,751 in payroll taxes.
During this period, the Van Dries purchased and made payments on a 2013 Tracker boat and trailer, a recreational vehicle, multiple vehicles including a 2010 Hummer and a 2009 Mercedes, several utility trailers, two golf carts, a motorcycle, expenses associated with two homes and family vacations in Florida, and a pulling truck called “Momma’s Money,” which Pamela Van Dries’ son used in pulling competitions throughout Missouri.
In addition to these two criminal conspiracies, Pamela Van Drie was found guilty of eight counts of healthcare fraud related to fraudulent claims for speech aid prostheses and 10 counts of healthcare fraud related to fraudulent claims for dentures and other dental services.
Pamela Van Drie also was found guilty of one count of theft of public money related to $3,520 in unemployment benefits that she was not entitled to receive while working full-time at All About Smiles.
From June 2012 through the end of December 2012, Medicaid paid into Pamela and Lorin Van Drie’s business bank account three-quarters of a million dollars. Also during that time period, Pamela Van Drie took a weeklong vacation to a resort in Florida.
Also from June 2012 through January 2013, Pamela Van Drie falsely certified to the Missouri Department of Employment Security 31 times that she was not employed, was available and searching for work, and was not receiving any type of employment income.
In addition to the payroll tax conspiracy, Lorin Van Drie also 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 that he was not entitled to receive while working at his own construction company and doing maintenance work at All About Smiles.
Under federal statutes, Lorin Van Drie is subject to a sentence of up to 10 years in federal prison without parole for theft of unemployment benefits and five years in federal prison without parole on each additional count of conviction. Sentencing will be determined by the court based on these guidelines and other statutory factors. A sentencing hearing has not been scheduled.
This case is being prosecuted by Assistant US Attorneys Cindi S. Woolery and Steve Mohlhenrich and Special Assistant US Attorney Shannon Kempf of the Missouri Attorney General’s Office. It was investigated by the Health and Human Services Office of Inspector General, the Missouri Attorney General’s Office Medicaid Fraud Control Unit, and IRS-Criminal Investigation.