Anchorage Dentist Seth Lookhart Convicted of Medical Assistance Fraud, Illegal Practice of Dentistry, Reckless Endangerment
January 17, 2020
The Alaska Department of Law, Medicaid Fraud Control Unit (MFCU), announces that in a verdict issued today by Superior Court Judge Michael Wolverton, following a five-week bench trial, Seth Lookhart was convicted of 46 counts of felony Medical Assistance Fraud, felony Scheme to Defraud, and misdemeanor counts of Illegal Practice of Dentistry, and Reckless Endangerment. Judge Wolverton also found Lookhart’s corporation “Lookhart Dental LLC, d/b/a Clear Creek Dental,” guilty of all 40 counts alleged against it. Lookhart’s office manager, Shauna Cranford, had previously pled guilty to all of the conduct underlying the counts pursuant to a plea agreement. Judge Wolverton found that the State’s evidence was “simply overwhelming” as to each count.
In a written order accompanying today’s verdict, Judge Wolverton stated that the evidence presented at trial established that Lookhart believed that he could get away with his fraud indefinitely, and that he believed his scheme was foolproof. Judge Wolverton found that Lookhart believed that unless “someone was standing right next to him at the time, no one would ever know.” Judge Wolverton found that the State presented “a substantial amount of forensic evidence,” and that the “overwhelming amount of evidence was often supported, and often in excruciating detail, by Lookhart’s own texts, photos and videos.”
Judge Wolverton found that Lookhart specifically intended to steal from the Alaska Medicaid program, that Lookhart did so by means of illegally practicing dentistry, and that Lookhart placed his patients in substantial risk of serious physical injury while doing so.
The prosecution acknowledges the many law enforcement agencies and civilians who assisted in the prosecution of this case, especially the former patients who testified during the trial. The State extends a special thanks to the “hoverboard video” patient, the patient whose teeth were pulled out without consent, and the patient who was forced to repeatedly return to Lookhart for remedial care. The State acknowledges the thorough work of the federal agents with the federal Department of Health and Human Services, Office of Inspector General, who provided substantial litigation assistance with this case. The prosecution also expresses thanks to the agents of the FBI Anchorage Field Office, the federal DEA, the State Department of Health and Social Services, the six doctors who provided extensive testimony at trial, and the many, many hours spent by the Medicaid Fraud Control Unit’s investigators and staff. The State extends a special thanks to Dr. Eric Nordstrom for his many hours of hard work as the State’s primary expert in this case.
The prosecution was gratified that Judge Wolverton requested thorough written closing argument as well as permitting lengthy oral summation from the attorneys. The prosecution appreciated Judge Wolverton’s able and thoughtful navigation of this deceptively complex area of regulatory law.
In the interest of a complete press release, the following description of this fraud is recapped from the original press release:
Dr. Lookhart, as a new dentist, was working for two established dentists in a practice called Alaska Dental Arts. Dr. Lookhart was to be paid the greater of $240,000 a year or 30% of the money he was able to generate. Dr. Lookhart was convinced by Cranford to begin offering IV sedation to Medicaid patients as an alternative to more common and less costly methods of anesthetizing a patient for a dental procedure. Dr. Lookhart and Cranford began to push IV sedation for Medicaid patients. The cost for the IV sedation is generally not included in the patient’s $1,150 annual limit for non-emergency procedures. This practice quickly became very lucrative for Dr. Lookhart resulting in his practice alone being responsible for 31% of the total Medicaid payments for IV sedation in 2016. IV sedation is governed by specific regulations that limit its approved use to a few narrow circumstances that must be properly documented.
Dr. Lookhart devised a scheme to cut out his then partners by billing Medicaid under a different provider ID and sending the money directly to his home. The estimated value of the fraud towards his partners is approximately $250,000 to $350,000. Additionally, private insurance generally does not cover IV sedation, so Dr. Lookhart began offering private pay clients the option of paying a $450 flat fee when he was billing Medicaid as much as $2,049 for the same service. Medicaid regulations specifically prohibit providers from billing Medicaid more than the general public is charged for the same service. Since obtaining his IV sedation license in 2015, Dr. Lookhart has been paid by Medicaid approximately $1.9 million for IV sedation services; he has billed Medicaid approximately $2.5 million.
The felony medical assistance fraud, theft in the first degree, and scheme to defraud charges carry a possible sentence of up to 10 years in prison, a fine of up to $100,000, and restitution to the State of Alaska Medicaid program and to his prior business partners. The top counts carry a potential fine of up to $2,500,000 for Lookhart Dental, LLC. The misdemeanor medical assistance fraud offenses carry a possible sentence of up to a year in jail, a fine of up to $25,000, and restitution to the Alaska Medicaid program for the individuals and a possible fine of up to $500,000 for Lookhart Dental, LLC. The misdemeanor unlawful dental acts offenses carry a possible sentence of up to 10 days in jail and a fine of up to $2,000.”
Judge Wolverton scheduled Lookhart’s sentencing for April 30, 2020. Cranford’s sentencing is currently scheduled for February 3, 2020 – though that date is subject to change.
At Lookhart’s sentencing hearing, Judge Wolverton will decide whether statutory “aggravators” apply to this case – as the prosecution has alleged. Those special factors in aggravation include allegations that Lookhart targeted vulnerable patients, that his crimes had multiple victims, and that he was a leader of a group committing both felonies and misdemeanors.
CONTACT: Assistant Attorney General Eric Senta at (907) 269-6462 or email@example.com at the Office of Special Prosecutions. Copies of the original charging document filed in this case and other matters handled by the Alaska Medicaid Fraud Control Unit can be found at http://www.law.state.ak.us/department/criminal/mfcu.html. Anyone who witnesses or wishes to report Medicaid fraud may contact the Medicaid Fraud Control unit at (907) 269-6279.
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Department Media Contact:Assistant Attorney General Maria Bahr at (907) 269-5285 or firstname.lastname@example.org.