Winter Park dentist arrested for Medicaid fraud

A Winter Park dentist was arrested last month after allegedly making more than $5,500 in fraudulent claims to Medicaid for procedures that were never performed on her child patients – some of whom fell victim to alleged medical malpractice.

Dr. Merys Downer-Garnette has been charged with one count of Medicaid provider fraud and one count of organized scheme to defraud. If convicted, Downer-Garnette faces up to 10 years in prison, as well as more than $10,000 in fines.

Attorney General Pam Bondi’s Medicaid Fraud Control Unit (MFCU) discovered the fraud by working with dental expert Dr. William Robinson, who reviewed patient x-rays and discovered that Downer-Garnette reportedly billed the Medicaid program for dental services on children that either never took place or were performed incorrectly, according to the arrest affidavit.

“These children were seen by Dr. Merys Downer-Garnette and Medicaid was subsequently billed for services that were never performed … and in some instances performed in such a poor, below standard of care that the treatment needs to be redone at great risk to these children … strictly for the financial gain of Dr. Merys Downer-Garnette,” the arrest affidavit reads.

But it wasn’t Downer-Garnette’s first time being charged with Medicaid fraud. The arrest affidavit reports that she voluntarily voided more than $87,000 in claims back in 2010, admitting that she billed the Medicaid system for services that were not provided.

The MFCU continues to see cases of Medicaid fraud in Orange County. Whitney Ray, director of media relations for the Office of the Attorney General, said that the Medicaid Fraud Control Unit has issued 11 Medicaid fraud arrest warrants in Orange County since January 2014. Six of the cases have been closed while five are still ongoing, Ray said.

One incident last March involved Tranquility Healthcare Solutions in Orlando. Four individuals were arrested for their part in a Medicaid fraud scheme that offered homeless men and women gas cards and temporary housing to pose as patients. The company allegedly made at least $215,000 in fraudulent claims, in addition to using medical personnel who were not properly trained.

“Taking advantage of the homeless to essentially steal from taxpayers is despicable and will not be tolerated in Florida,” said Attorney General Bondi in a news release. “I applaud my Medicaid Fraud Control Unit for its efforts to shut down this elaborate fraud scheme.”

A $3 million Medicaid fraud scheme took place in the outskirts of the city of culture and heritage. Janie Vittini, owner of the Improving Together clinic off of Aloma Avenue, was arrested by the MFCU in March 2013 for Medicaid fraud, racketeering and identity theft. The owner reportedly used the funds to purchase luxury vehicles, trips and jewelry.

From January 2011 to August 2015, the MFCU has obtained more than $495 million in settlements and judgments.

Ray said that Downer-Garnette’s case is still ongoing, but could not reveal more details.