D.A.’s Office to Present $400,000 in Restitution to Over A Dozen Victims

Insurers, Bilked Out of Thousands in Dental Scam, Receive Funds Wednesday, 14 June @ 9:30 A.M.

Atlanta—On Wednesday, 14 June, at 9:30 A.M.*, representatives from more than a dozen insurance companies will be presented with their portion of over $400,000 in restitution by Fulton County District Attorney Paul L. Howard, Jr. The funds were secured for them—and over 40 other victims—by the District Attorney’s White Collar Crime Unit, working with the Georgia Insurance Commissioner’s Office, in its recent prosecution of Edward R. Ekkebus (52). The event will take place at the Office of the District Attorney, 136 Pryor Street, SW, 3rd floor.
Ekkebus, who owned the Lee Dental Center at 18 Marietta Street in downtown Atlanta, pleaded guilty in March to five counts of insurance fraud for knowingly and willfully making false and fraudulent statements of material fact in the filing of dental claims. The defendant deceived scores of insurance companies into paying him hundreds of thousands of dollars over several years. His scheme essentially involved the “upcoding” of procedures as well as billing for services not rendered. (An example of upcoding might be the filing of a claim for reimbursement for a gold filling when the patient actually received only a silver one.)

While the District Attorney’s Office had asked that the defendant be sentenced to incarceration, he received a sentence of house arrest for six months (followed by probation for 10 years). He was also fined $10,000 and ordered to reimburse the Insurance Commissioner’s Office $6,500 for the cost of its investigation. Perhaps most significantly for the victims in this case, Ekkebus was ordered to pay $400,000 in restitution—every penny of which has already been received. (The $400,000 will be repaid to the 56 victims this week—including those who are able to attend the event on Wednesday.) During his house arrest, Ekkebus must wear an ankle bracelet and is only permitted to leave his house to perform community service, visit his probation officer, attend church, and for medical attention. He must also perform 2,000 hours of community service. He is prohibited from any association with any business that provides dental, health, or medical-care services or one that receives its income or reimbursement from insurance claims. Nor may he engage in any business in which he solicits funds from the public.

The Case of the Two-Timing Teeth
The defendant’s scheme unraveled in March 2000 when a dentist not affiliated with the Lee Dental Center submitted an insurance claim for services rendered in February 2000 for the removal of four teeth. The insurance company denied payment for these services as its records showed that the patient’s same teeth had been removed already by the Lee Dental Center in 1994. The dentist appealed the denial and provided evidence to prove that he had actually extracted the teeth. The patient then stated that she had indeed visited the Lee Dental Center years earlier but could not remember specifically what work was performed. The insurance company notified the Fraud Unit of the Insurance Commissioner’s Office of possible fraudulent acts perpetrated by the Lee Dental Center. An investigation was begun, and a search warrant executed in August 2001.

Chief Senior Assistant District Attorney Brad Malkin of the White Collar Crime Unit prosecuted the case. Special Agent Sherry Mowell of the Georgia Insurance Commissioner’s Office investigated. Judge Jerry Baxter presided.

*Media with cameras are welcome and encouraged to attend.

CONTACT: Erik Friedly, 404.224.0560 (office); 770.583.6069 (pager); erik.friedly@co.fulton.ga.us