Sacramento dentist pleads guilty to defrauding UPS health care plan

A Sacramento dentist has pleaded guilty to defrauding United Parcel Service employees’ health care benefit program by billing for unnecessary dental work and for work that was not performed.

David M. Lewis, 62, entered the plea Monday in federal court in Sacramento, according to a U.S. Attorney’s Office news release.

Court documents show that beginning in late 2008 or early 2009, Lewis began targeting UPS employees for dental treatment because their health care benefit under the Northern California General Teamsters Security Fund provided 100 percent coverage without annual limits. Lewis offered cash and other incentives to UPS patients for receiving dental treatment or for recruiting other UPS employees to receive treatment.

Lewis’ office in some instance submitted claims to the plan administrator, Delta Health Systems, for work never performed, authorities said. In other instances, Lewis performed unnecessary dental work on UPS employees, including root canals, and those claims were submitted to Delta for payment.

To justify the work, Lewis created some false narratives about purportedly pre-existing dental conditions. In other instances, authorities said, Lewis drilled into teeth to install temporary fillings and instructed his assistants to take X-rays of the temporary fillings. Lewis then submitted claims with X-rays he said depicted tooth decay justifying further dental work.

The total losses associated with Lewis’ health care fraud may be as high as $1 million, authorities said.

An employee at Lewis’ dental practice, Nichol Ramirez, also known as Nichol Lomack, previously pleaded guilty to one count of health care fraud for her part in the scheme.

Lewis faces a March 31 sentencing before U.S. District Judge Morrison C. England Jr. Lomack is to be sentenced Sept. 1.

This story was originally published January 11, 2016 at 3:49 PM with the headline "Sacramento dentist pleads guilty to defrauding UPS health care plan."