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Letter: Attorney Writes to Melissa Nelson on Medicaid Billing Fraud Scheme

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Attorney William N. Spicola Writes to Melissa Nelson on Medicaid Billing Fraud Scheme

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by William N. Spicola

This is in regards to a letter to  Melissa Nelson, State Attorney for Florida’s Fourth Judicial Circuit Re: Jacksonville Dentist Dr. Howard Fetner involvement in South Florida.

I write to make you aware of a Jacksonville dentist, Dr. Howard Fetner, and his involvement in a Medicaid billing scheme in South Florida.

I represent three clients who are licensed dentists – Dr. Christina Puig, Dr. Alejandra Sanchez, and Dr. Dayrys Tejeda, as well as Diana Parra.

These three licensed Florida dentists were terminated by Jacksonville dentist, Dr. Fetner, in December 2022 even though Dr. Fetner had never set foot in their South Florida office.

Our clients believe their termination was the penalty for reporting that their billing codes were being improperly used by their former employer, ACPDO Management, Inc., without their consent.

Drs. Puig, Sanchez, and Tejeda has never had any contact with Dr. Fetner before he terminated them for reporting billing fraud. Moreover, public records obtained from the Office of Financial Services’ investigation into these Medicaid billing frauds indicate multiple legal violations related to Dr. Fetner’s involvement in the scheme. (Exhibit 1) I have also included records from the 11th Circuit State Attorney’s Office (Exhibit 2) and additional records from the Department of Financial Services. (Exhibit 3)

The Department of Financial Services report alleges a $2,274,371.49 fraud involving Dr. Fetner and others and summarizes the recommended charges against the Dr. Fetner.

The summary report states that, Howard Fetner Violated one count of FSS 817.234 l(A)l False and fraudulent insurance claims.

Howard Fetner violated one count of FSS 817.034 Scheme to Defraud by taking part in a systematic, ongoing course of conduct intending to defraud by continuing billing under

Dr. Ania Cabrerizo’s NPI, knowing that Cabrerizo was no longer employed.

Howard Fetner violated FSS 817.568 Criminal use of personal Identification by receiving and allocating funds collected under Doctors Cabrerizo, Velez, Sanchez, Roman, Tejeda, Puig, and Delgado’s Class One Pis for services not administered or supervised by them. Howard Fetner Violated FSS 812.014 and committed Grand Theft. Dr. Fetner allowed medical billing claim to be presented, submitted, and paid under Doctor Cabrerizo, Tejeda, Sanchez, Puig, Delgado, Velez, and Roman’s NPIs with the intent to deprive the insurers.

As I am sure you are aware, Florida law does not allow a person who is not a licensed dentist to own or operate a dental practice in Florida.

My clients have information about the involvement of Dr. Fetner and his role in terminating them after they objected to their billing codes. being used without their knowledge or approval for Medicaid billing. My clients are ready to help your office with protecting Duval County residents from the unlawful actions of a dentist in your jurisdiction.

William N. Spicola is a Tallahassee attorney.

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Ed Dean: Publisher

Ed Dean is a leading radio and news media personality including hosting the #1 statewide radio talk show in Florida. Contact Ed.Dean@FloridaDaily.com

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