Discover the best of the web!
Learn more about Digg by taking the tour.
Unbelievable! Medicaid Investigation Ruins Good Dentist
medicaidruinsgooddentist.c… — Awful story of how a wrongful Medicaid fraud investigation ruined a dentist and his family in Virginia. He was the only dentist providing treatment to Medicaid patients in his rural area and was punished for it. He was found guilty on Thursday and faces up to 120 year jail sentence. Please Digg this to the top and get his story out there !
vicarbo- 39 diggs
- digg it
- mikebarrdds, on 05/05/2008, -0/+0Spread the word!!
- carol0717, on 05/05/2008, -0/+0Please forward this to everyone you know!
- mikebarrdds, on 05/05/2008, -0/+0Visit the website: www.MedicaidRuinsGoodDentist.com!
And, pass it on! - diggduggdudd, on 05/05/2008, -0/+0I'm a dentist and I own 12 computers, very lavish indeed. Guess I should go away for at least 150 years. It would be so refreshing to see the Justice Department actually go after criminals. But hey, I guess that only happens in a free country like Americ.....OH SH**!! this IS America
www.MedicaidRuinsGoodDentist.com GO THERE TO FIND OUT! - pete1821, on 05/06/2008, -0/+0Digg dugg done and keep it going people! Gotta get more people on this important story!
- johndds, on 05/06/2008, -0/+0Open letter to the Judge in this case.
I have read the story of Dr. Roy S Shelburne
My Grandfather served in WW1 and was killed in WW2, my father served in the Korean conflict. To think that they laid down their lives for this country so that this government could ruin one of its citizens lives in the name of the “Abu Graib Patriot Act”. I am disgusted with my government at this moment that for an alleged $8,000 in an office that collected over $2 mil the government would ruin a man in my profession. It is in your hands to show this government is wrong in their attack on its good citizens.
I plead you consider sending a message that what these thugs have done is wrong and goes against all we Americans have fought and died for. In this case, set this judgment aside, notwithstanding the verdict as it appears, for the entire world to see, that this judgment was based on inappropriate application of law and emotion, rather than the rule of law. It appears to me to be an untenable, egregious miscarriage of justice. SAY NO TO INJUSTICE.
I understand In this case there was a "whistle blower(s)". The identity of this person(s) is protected by the government and will receive up to 25% of the penalties/fines. There was a great deal of incentive for the "whistle blower" to concoct a story to support the government’s position in the case.
THAT STINKS! - mattyarbro, on 05/06/2008, -0/+0WOW>>>>>>>>>>>>>..
Medicaid is gonna end in my office ASAP. WOW...
USSR...........now USA........soviet style - mpotluri, on 05/06/2008, -0/+0I have just read this story about Dr. Roy Shelburne. I practice in Canada and we don't have Medicaid here but i have friends in the states that use it. It's horrifying and my heart goes out to the doctor and his family. There are so many criminals and psychopaths out there that are running freely in the society harming the innocent. I can not believe that the gov is punishing this man for a $10,000. Even if he has made some mistakes, he doesn't deserve prison sentence of any length of time. Is the court blind so as not to see that so many poor families will be affected by this as most of the dentists will stop using Medicaid for good???What are they trying to prove? If they wanted to make a point, so they did it. 5 yrs of trial /torture for Dr.Sheburne is enough for any dentist that is in fact involved in fraud to stop doing that. ( I don't believe any doctor would do that for few thousand dollars. We have taken an oath, remember)? I pray with all my heart and am going to write a letter of support. I hope every dentist who reads it will do the same.
- IFixTeeth2000, on 05/07/2008, -0/+0And throughout the whole case the only real "issues" were clerical errors made by his staff. Scary. Scary. Scary.
- eeznogood, on 05/07/2008, -0/+0PLease spread the word. I'm not even an american. I am Canadian. But how could anyone read the story and do nothing. SPREAD THE WORD!!! THEESE PEOPLE ARE NAZIS!!!
- TruthSerum1, on 05/08/2008, -0/+0It is an awful story! Especially when you live here and know that the Shelburne's 'story' has many untruths in it and was written by the dr and son, not a reporter or news wire. Dr Shelburne is not the only medicaid provider in the county, we have a clinic 6 miles from his business and another about 20 miles away. dr shelburne was NOT the ONLY medicaid provider in the area. Also, it was reported in the bristol herald courier, that the money he was found guilty over, was in the HUNDREDS OF THOUSANDS, NOT the $8000.00 that the Shelburnes have wrongly stated and you bloggers are repeating.
- icedancertoo, on 05/09/2008, -0/+0I can't imagine "150 false billings" would amount to "HUNDREDS OF THOUSANDS", although perhaps more than $8000. No one will know for certain until the court transcripts become available. The following link provides newspaper reports from the court proceedings...an interesting "read" for both sides of the debate as well as those who are on the fence.
http://limoli.com/tricities%20aticles.pdf
After reading this 22 page long pdf document, I tend to believe that he is being dragged through the mud by overzelous prosecutors. - TruthSerum1, on 05/10/2008, -0/+0Lee County, Va., Dentist Continues To Practice After Last Week's Guilty Verdict
Wednesday, Mar 12, 2008 - 01:45 AM
BY Daniel Gilbert
PENNINGTON GAP, Va.– Days after a jury found dentist Roy Silas Shelburne guilty of victimizing young, low-income patients and bilking Medicaid for hundreds of thousands of dollars, he is back cleaning teeth and billing the state health-care agency.
Last Thursday, a federal jury found the dentist guilty of 10 felonies, including racketeering, health-care fraud and money laundering. He faces up to 120 years in prison and a $1.25 million fine.
During the three-week trial, prosecutors laid out a scheme in which Shelburne, 51, performed unnecessary procedures on children, and defrauded Medicaid and private insurance companies by billing for procedures he did not perform, and collecting from both.
Shelburne’s license is current and active, according to state health officials, and he is not breaking any law by practicing.
The director of the Virginia Department of Health Professions is bound by law to "immediately suspend" the license of any practitioner convicted of a felony.
But the jury’s verdict does not carry the weight of a conviction until the sentencing phase, two state health officials said Tuesday, citing state and federal law.
Sandra Whitley Ryals, director of the state agency, said she would not have the authority to suspend Shelburne’s license until after his sentencing, which is set for June 9.
But state health boards have another means of suspending a license. Any health regulatory board can suspend a practitioner’s license if it finds that person poses a "substantial danger to the public health or safety," according to Virginia law.
Sandra Reen, executive director of the Virginia Board of Dentistry, said Tuesday the board "can investigate the matter and decide what action to take within its authority."
She declined to say whether an investigation of Shelburne has been opened or is pending.
Authorities hailed Shelburne’s conviction last week.
"This dentist victimized children and low-income families, as well as the Medicaid system," Virginia Attorney General Bob McDonnell said in a March 6 statement.
Asked to comment on Shelburne’s continuing practice, a spokesman for the attorney general said, "We don’t have any comment on that."
At his dental practice in Pennington Gap on Tuesday, Shelburne had no comment.
But Kelly and Crystal Willis, who brought in their four children for routine teeth-cleaning on Tuesday, said the embattled dentist they’ve been seeing for four years has "good character."
The family from Big Stone Gap, Va., is a slice of the demographic Shelburne is accused of victimizing. The couple’s four children – ages 8, 6, 4 and 2 – receive Medicaid benefits. The couple said they’d heard about the criminal allegations after their last appointment several months ago, and that Shelburne himself informed them Tuesday of last week’s verdict.
But the charges and guilty finding weighed little with them.
"He’s excellent with our kids," said Kelly Willis. "We’ve had no problems. We talk to him like you talk to a neighbor, and he knows my kids by name."
Crystal Willis said, "I don’t care what he’s done in his personal life. He’s been good to us and our kids, and that’s all that matters." - TruthSerum1, on 05/10/2008, -0/+0Noone is asking anyone to 'imagine' anything, this is reality, real life, not a dress rehearsal. If the newspaper misrepresented the truth, Roy can force them to retract or sue them. He needs the cash for his appeal or he wouldn't ask for donations. The first paragraph plainly states 'hundreds of thousands of dollars', if Roy is right he should take it up with the bristol paper and the reporter. He should take the transcripts that state 8000.00 and have them published. Official transcripts that is.
- icedancertoo, on 05/10/2008, -0/+0Please know that Dr. Shelburne himself did not ask for donations at all. He simply posted his story on the DentalTown forum message board as a warning to all dentists who take Medicaid that they are at risk of the same fate (that is all his intention was). Many of the dentists on DT after reading his story thought that it was inappropriate to take away all of his assets so that he cannot even fund a decent defense. It was one of the "Townies" who asked Dr. Shelburne if he could start a website to get his story out. It was also another Townie member who suggested that we start up a donation fund so that he can fight it if he is granted an appeal opportunity. Please do not think that Dr. Shelburne was asking for anything...it was simply a warning and nothing more.
Apparently they went after the amount of money that was "false billings" from the 150 claims and because of the "fraud" they also wanted to entire billed amount from the claim, therefore adding a great deal more (this is where the hundreds of thousands comes in, I believe). But, for 150 "false billings" from 1998 to (I believe) 1996...this could easily happen in any dental office from clerical error (but, there is no exclusion in the Medicaid contract that would dismiss the possibility of human error).
He didn't even charge for Nitrous oxide sedation, which was indicated to be a covered service. He also participates in charity work. Not that these would make him innocent, but to present the jury with pictures of his home and lifestyle as "evidence" of fraudulent activity, that is scary. Gee, I have a couple hundred thousand in student debt...guess that would be evidence that I am carrying on fraudulent activity.
I'm not 100% for him yet, but something is definitely not right with the judicial system there. - pcarfan, on 05/11/2008, -0/+0I can't believe things like this can really happen here, what is this country coming to? I am sick!
- TruthSerum1, on 05/11/2008, -0/+0
'This website was created by a dentist who has never met Dr. Shelburne.' And the so called dentist never puts his name credentials, location,etc. Who in their right mind is gonna believe the writing of an anonymous person, who doesn't even know Roy? Roy, you need to get off of the net and get out and enjoy things, weather, family, fresh air, freedom, a nice long drive, a visit to someone you've not seen in a while, a day with you MOTHER would suffice!. Do something positive after church. Start anew. Get the anger out of your heart, Lee co isn't against you, you are against Leeco. It saddens me to see locals HATE the area as a whole over a certain incident. We had a reunion a few months ago, one of our classmates was contacted and said, 'he'd just as soon pretend lee county never existed in his life' and was a no show. His hate was toward 1 certain family, I know,we were best friends, and he now blames the whole area. ME included. It's sad, but nothing I can do , because I did nothing to cause these ill feelings and my apology for those who did would be useless.
Also, this story is printed in the NEWS section. What is the web addy of the News where it was actually reported ? I can't find any press report titled "Medicaid Investigation Ruins Good Dentist"? Is there one? - TruthSerum1, on 05/11/2008, -0/+0Supporters Of Lee County, Va., Dentists Can't Believe Guilty Verdict
Friday, Mar 07, 2008 - 01:30 AM
BY Debra McCown
Send e-mail
Bristol Herald Courier
ABINGDON, Va.– Roy Silas Shelburne will face up to 120 years in prison and a fine of up to $1.25 million after his conviction Thursday on 10 felony charges involving his dental practice in Pennington Gap, Va.
After more than seven hours of deliberations over two days, a federal jury found Shelburne guilty of health-care fraud, racketeering, structuring a transaction to avoid reporting requirements and seven counts of money laundering.
His wife and three grown children, who have supported him throughout the lengthy ordeal, burst into sobs, surrounded by tearful supporters as the jury read its verdict.
"All things work for the good of those who love the Lord and according to his purpose, even this," Shelburne said as he left the courtroom Thursday afternoon. "May he be glorified."
Shelburne remains free on bond pending sentencing June 9.
"We’re just flabbergasted," said his mother, A. Drucelle Shelburne, after the verdict was read. "It’s just absolutely unbelievable – inconceivable."
The trial was attended by about two dozen supporters – family members and friends who maintained their belief in his innocence.
"All things work together for those who love the Lord," said daughter, Erika, echoing the statements her father has made since his 2006 indictment.
With a successful dental practice that allowed him to pay for a large home, expensive cars and extravagant trips to do charity work abroad, Shelburne had been considered a pillar of his Lee County community.
Based on state code, his conviction means the immediate suspension of his license to practice dentistry, effectively shutting down his practice.
At least two of his employees were present when the verdict was read Thursday.
"It was a wonderful place to work, and things was said untrue from people who testified against him," said one staff member, speaking for herself and a colleague. "He’s kind and considerate, and he’s the best dentist I’ve ever worked for."
The women did not give their names, citing concerns that their comments might make it difficult for them to find new jobs.
U.S. Attorney John Brownlee said Shelburne abused a position of trust as a dentist to whom families came for help when they needed dental treatment, and he performed painful, unnecessary procedures on children to satisfy his greed.
"Shelburne’s criminal conduct toward these poor families and young foster children is one of the worst cases of abuse and fraud I have seen in my many years in law enforcement," Brownlee said.
"I’m just grateful to the jury for holding him accountable for his conduct."
Pennington Gap dentist found guilty of racketeering, fraud
ABINGDON — Pennington Gap dentist Roy Silas Shelburne was found guilty Thursday by a federal jury in Abingdon of 10 felony charges including racketeering, health care fraud, mail fraud, wire fraud and money laundering
According to a news release from U.S. Attorney John L. Brownlee and Virginia Attorney General Bob McDonnell, Shelburne, 51, now faces a maximum penalty of 120 years imprisonment and a fine of $1.25 million. As a result of the conviction, Shelburne has agreed to forfeit $200,000 to the federal government in addition to mandatory restitution in an amount to be determined by the court at sentencing. Shelburne remains free on bond pending his sentencing hearing June 9 in Abingdon.
“Roy Shelburne acted in a cruel and inhumane manner by performing unnecessary and extremely painful dental procedures on children. Shelburne’s criminal conduct toward these poor families and young foster children is one of the worst cases of abuse and fraud I have seen in my many years in law enforcement,” Brownlee said.“I am grateful that this jury held Mr. Shelburne responsible for his crimes. My thanks and gratitude go out to all the state and federal agents and prosecutors who worked tirelessly to bring the defendant to justice.”
Shelburne was found guilty of racketeering, health care fraud, structuring and money laundering. The charges arose from a joint investigation conducted by the Virginia Attorney General’s Medicaid Fraud Control Unit, the IRS and the U.S. Attorney’s Office.
According to the evidence presented at trial by Assistant U.S. Attorney Anthony P. Giorno and Assistant Attorney General Michelle Brooks, beginning in 1998 Shelburne, who was a licensed dentist with a practice in Pennington Gap, executed a scheme to maximize his practice’s income by overbilling insurance carriers and Medicaid for services that were never performed and for services that were performed but not medically necessary.
In addition, Shelburne directed his employees to bill patients for services that were never performed or that were unnecessary. All of the patients Shelburne falsely billed were low-income, underage patients who were recipients of Medicaid. A portion of the underage patients were residents of the Harvest Child Care Ministries group home.
According to the evidence presented at trial, Shelburne would “upcode” the bills for some of his patients.“Upcoding” is the process of performing one procedure but billing for a different procedure, one that requires a higher payment from Medicaid and private health insurance providers.
In some cases, Shelburne would submit bills for services that were incomplete or medically unnecessary. At times, he performed services that endangered the health of his patients.
On several occasions Shelburne billed both Medicaid and private health insurance companies for services he performed in connection with a single procedure, collected money from both agencies, and failed to reimburse either for the fraudulent fees he collected. Many times this created credit balances on the patients’ account that, according to his employees, Shelburne would simply “zero out” without reimbursing Medicaid.
According to the evidence presented at trial, Shelburne submitted at least 115 false billing statements by mail. The defendant took part of the fraudulently obtained funds and transferred them into a retirement account in Illinois. The evidence showed that Shelburne used some of the funds to build a new home known to his employees as the “Cavity Castle,” purchase luxury vehicles for himself and his family, and took his family on cruises that were deducted on his books as board expenses.
In addition, he put his three children on the company payroll when, according to his employees, they provided no services. The salaries paid to the children were deducted as business expenses. Shelburne used part of the fraudulently obtained funds to pay his salary, purchase dental supplies, and pay rent for his business and equipment.
In addition, Shelburne was convicted of structuring cash deposits at both BB&T Bank and Rick Hill Imports, a luxury car dealership, in an attempt to evade the currency transaction reporting requirements. With the structured funds, he purchased a used 2006 Mercedes SUV and a new 2006 Mercedes SLK coupe in the names of family members.
On cross-examination, Shelburne testified that the structured funds were part of a cash horde that he had accumulated to hide assets from investigators.
- TruthSerum1, on 05/11/2008, -0/+0I read where there were 115 billing mistakes. Where did you get the 150? Where are the other 35 mentioned?
- kwalia, on 06/18/2008, -0/+0I found out about this yesterday and visited the website. I think this is the most ridiculous thing I have heard. I am going to be spreading the word!
- friendlydds, on 06/24/2008, -0/+0I'm surprised that everyone is so quick to call our government wrong and assume the innocence of a dentist that they don't know. Sure, I don't think that the punishment fits the multiple crimes.
It is is very fashionable to be anti-American at this point in time and so maybe all of you want to be in with the likes of Sean Penn, Al Franken, Bono, Neal Young... Bottom line was that a jury found him guilty. I've read some of the dialog and I'm not sure how you people are inferring that this was all just clerical errors. - TruthSerum1, on 07/08/2008, -0/+0"Unbelievable" for sure, aren't lies are usually that way? The first word should be ample warning to the body. friendly, he doesn't have the support , he is posting under several different nicknames in support of himself. He's turning more against him than for him. A person with an ounce of logic, can split the 2 sides, roy's side and the truth. He was lacking his own families support until trial, etc. They were disappointed and upset with him during the investigation and they made sure he was aware of their feelings. IMO the man has had a nervous breakdown, he's in denial of reality. Further psychosis lead to him getting online to stir up trouble after assuming several nics/personalities. He needs help, this is a cry for it.
- twintuitive, on 07/09/2008, -0/+0NO!!! don't spread the word! He was defrauding our government and performing unnecessary (and painful) procedures on little kids to make money!!! that's evil! Don't believe him, I've read the entire investigation. he's definitely guilty of doing those things! Don't let him give you that bull**** sob story, it's just a lie......just like how he lied to Medicaid to get extra money. fool me once shame on you, fool me twice shame on me. right?
- TruthSerum1, on 07/10/2008, -0/+0Right! Where did you read the investigation?
- TruthSerum1, on 07/10/2008, -0/+0
http://flapsblog.com/2008/06/17/the-case-of-dentis ...
http://www.topix.net/forum/city/jonesville-va/TQ9U ...
Digg is coming to a city (and computer) near you! Check out all the details on our 
© Digg Inc. 2008 —
Content posted by