SPRINGFIELD, Mo. – A federal grand jury indicted a husband and wife from Marshfield for their roles in health care fraud and payroll tax fraud schemes that totaled more than $1 million.
Pamela Van Drie, 57, and her husband, Lorin Van Drie, 57, are charged in a 40-count indictment returned under seal by a federal grand jury on Wednesday. That indictment was unsealed on Thursday after the arrest and initial court appearance of Pamela Van Drie.
Pamela and Lorin Van Drie owned All About Smiles, a company in Springfield that provided dental services at clinics in Springfield (until it closed in November 2015), Mountain Grove (until it closed in October 2014) and Bolivar (until it closed in March 2014). They also owned PL Family Management Company, which managed the staff for those clinics.
$885,748 Health Care Fraud Conspiracy
The indictment alleges Pamela Van Drie participated in a conspiracy to commit health care fraud from Oct. 6, 2010, to Aug. 19, 2015.
According to the indictment, this conspiracy consisted of a fraud scheme related to dentures and other dental services and a fraud scheme related to orthodontic appliances. Both fraud schemes involved fraudulent Medicaid claims and payments.
Pamela Van Drie and a dentist at the clinics arranged for All About Smiles to provide dentures and other dental services to adults who did not qualify for Medicaid reimbursement. Investigators believe they submitted claims to Medicaid for those dentures and other dental services, knowing that Medicaid’s requirements were not met.
The indictment alleges Pamela Van Drie, through All About Smiles, submitted and received $720,048 on numerous claims for dentures and other dental services that lacked the required written referral from a physician.
Additionally, according to the indictment, Pamela Van Drie and a dentist at the clinics purchased Oroth-Tain orthodontic appliances (designed to straighten teeth without braces) for approximately $50 each, provided them to Medicaid pediatric beneficiaries, and billed each such appliance to Medicaid as a speech aid prosthesis for approximately $695. They knew the Ortho-Tain appliances should have been billed to Medicaid as orthodontic services, the indictment says; they also knew Medicaid did not cover orthodontic services unless the Medicaid program’s requirements were met and they received precertification, which required review by a dentist/orthodontist employed by Medicaid. They allegedly billed the Ortho-Tain appliances as speech aid prostheses in order to bypass the precertification requirement.
Between Oct. 6, 2010, and Aug. 19, 2015, Pamela Van Drie submitted and received payment for approximately 241 claims submitted for speech aid prosthesis. On each claim, All About Smiles was paid between $675 to $695, for an approximate total amount of $165,700.
$194,751 Payroll Tax Fraud Conspiracy
In addition to the health care fraud conspiracy, Pamela and Lorin Van Drie are charged with participating in a conspiracy to defraud the government by failing to pay over the IRS payroll taxes from Jan. 31, 2013, to Jan. 31, 2015. Although payroll taxes were withheld from the paychecks of employees at All About Smiles and PL Family Management Company, the indictment says, the Van Dries failed to pay over to the IRS approximately $194,751 in payroll taxes.
According to the indictment, the Van Dries diverted substantial amount of money from their businesses during this period. They allegedly caused All About Smiles and PL Family Management Company to make thousands of dollars for their personal benefit while failing to pay over to the IRS payroll taxes withheld from their employees’ paychecks.
Rather than paying the payroll taxes due and owing, the indictment alleges, 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), diamonds, 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 Drie’s son used in pulling competitions throughout Missouri.
In addition to the two conspiracy charges, Pamela Van Drie is charged with eight counts of health care fraud related to fraudulent claims for speech aid prosetheses, 10 counts of health care fraud related to fraudulent claims for dentures and other dental services and one count of theft of public money related to unemployment benefits that she was not entitled to receive. Lorin Van Drie is also charged with one count of theft of public money related to unemployment benefits that he was not entitled to receive and 18 counts of failure to pay over employment tax.
The indictment also contains a forfeiture allegation, which would require Pamela Van Drie to forfeit to the government any property derived from the gross proceeds traceable to the alleged offenses, including at least $885,748.
The Department of Health and Human Services – Office of Inspector General, the Missouri Attorney General’s Office Medicaid Fraud Control Unit and IRS-Criminal Investigation worked together on the investigation.