The board said Sassan Bassiri was “driven by greed.” It said he had systematically defrauded Medicaid for six years, starting only weeks after he first opened his practice in Winston-Salem.
Bassiri used Medicaid payments to buy a house worth nearly $1 million, condominiums in Myrtle Beach, South Carolina, tracts of land in North Carolina, expensive cars and a new office building, according to the board’s filings.
The ruling from the board was made March 17. Bassiri must surrender his license by April 18.
Steven Shaber, an attorney representing Bassiri, told the Winston-Salem Journal Monday that the dentist has not decided whether he will appeal. “We are really disappointed at the outcome of the board’s decision,” Shaber said. “The whole case was about whether he did this on purpose or by mistake.”
Shaber said Bassiri acknowledges “making a terrible mistake” and is trying to work out a plan “to completely repay Medicaid.”
Shaber said he does not believe Medicaid has filed any criminal charges against Bassiri as of now. Medicaid has a major effort underway to tackle physicians who overbill.
The state board ruled that Bassiri’s misconduct was “the result of a well-thought-out and deliberate pattern of … submitting inflated bills that were materially false or misleading, rather than as the result of ignorance, misunderstanding or mistake.”
The board ruled that Bassiri improperly used the wrong reimbursement codes about 19,000 times “for which he collected approximately $1 million” from the North Carolina Division of Medical Assistance. The filings do not make clear how much of the $1 million was overbillings.
Bassiri came to the United States from Iran when he was 18, Shaber said. He graduated from North Carolina State University with a degree in electrical engineering. After graduating from the dental school at the University of North Carolina at Chapel Hill, he received his license in September 2003.
According to the board, in December 2003 Bassiri began a pattern of misconduct that continued until at least the end of 2009.
Bassiri was found to have billed Medicaid for dental work that either was not done or was medically unnecessary. He also was found to have exaggerated the nature and scope of some treatments he or staff members performed.
The board said Bassiri used reimbursement codes that provided him with a higher payment than typically paid for the services he actually rendered.
For example, the board said a review of his office books found that there were times when Bassiri properly billed for services for patients with private or no insurance, but used the incorrect code for Medicaid patients.
Medicaid is the US federal health program for the poor.
The board said its decision was based in part on Bassiri’s lack of genuine remorse and unwillingness to accept full responsibility for his misconduct.
The Division of Medical Assistance “was fraudulently deprived of substantial sums of money as a result of the respondent’s dishonesty,” the board said. “Those funds could have been used to provide much-needed dental services to other indigent citizens of our state, including children.”
The board said Bassiri has not taken any steps to rehabilitate himself. “Consequently if [he] is permitted to practice, the hearing panel finds there is a risk that he will engage in further misconduct.”