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Mira Mesa dentist gets six years for false claims to insurance companies

SAN DIEGO (CNS) – A former Mira Mesa dentist who bilked insurance companies out of hundreds of thousands of dollars by submitting claims for procedures she never performed, including hundreds of supposed root canals, has been sentenced to six years in state prison, the San Diego County District Attorney’s Office announced today.

April Rose Ambrosio, 59, pleaded guilty to three counts of insurance fraud earlier this year for fraudulently billing insurance companies for $866,700, for which she received more than $400,000 from 10 insurance companies, according to prosecutors.

The DA’s Office said Ambrosio falsely claimed she performed 800 root canals on 100 patients, despite not having specialized training as an endodontist to perform such procedures.

Ambrosio was sentenced earlier this month, and in addition to a six- year prison term, was ordered to pay $405,633 in restitution. Her license to practice dentistry was also suspended last year, a few months after she was charged.

Prosecutors say the fraud occurred between 2014 and 2018. During that time, Ambrosio billed for work she said occurred on days her office was closed and billed for more than 100 root canals during a three- month period, all of which were supposedly performed for a family of four, according to the DA’s Office. She also billed for root canals on teeth patients didn’t have or double billed for teeth she previously said she performed root canals on, the DA’s Office said.

“The way this defendant bilked the system is astounding,” District Attorney Summer Stephan said. “Unfortunately, when insurance companies get ripped off, consumers ultimately pay the price through higher premiums.”

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health

Debunking the False Claim That COVID Death Counts Are Inflated

A persistent falsehood has been circulating on social media: the number of COVID deaths is much lower than the official statistic of more than 218,000, and therefore the danger of the disease has been overblown. In August President Trump retweeted a post claiming that only 6 percent of these reported deaths were actually from COVID-19. (The tweet originated from a follower of the debunked conspiracy fantasy QAnon.) Twitter removed the post for containing false information, but fabrications such as these continue to spread. U.S. Representative Roger Marshall of Kansas complained in September that Facebook had removed a post in which he claimed that 94 percent of COVID-19 deaths reported by the Centers for Disease Control and Prevention “were the result of 2-3 additional serious illnesses and were of advanced age.”

Now some facts: Researchers know beyond a doubt that the number of COVID-19 deaths in the U.S. have surpassed 200,000. These numbers are supported by three lines of evidence, including death certificates. The inaccurate idea that only 6 percent of the deaths were really caused by the coronavirus is “a gross misinterpretation” of how death certificates work, says Robert Anderson, lead mortality statistician at the CDC’s National Center for Health Statistics.

The scope of the coronavirus’s deadly toll is clear, even if final numbers will not be known until the pandemic is over. “We’re pretty confident about the scale and order of magnitude of deaths, but we’re not clear on the exact number yet,” says Justin Lessler, an infectious disease epidemiologist at the Johns Hopkins Bloomberg School of Public Health. To understand why the figures contain some uncertainty, it is important to know how they are collected and calculated.

The first source of death data is called case surveillance. Health care providers are required to report cases and deaths from certain diseases, including measles, mumps and now COVID-19, to their state’s health department, which, in turn, passes this information along to the CDC, Anderson says. The surveillance data are a kind of “quick and dirty” accounting, says Shawna Webster, executive director of the National Association for Public Health Statistics and Information Systems. The states gather all the information they can on these diseases, but this is the first pass of the accounting—no one has time to double-check the information or look for missing lab tests, she says. For that, you have to look for the next source of information: vital records.

US deaths per week broken down by cause of death


Credit: Youyou Zhou; Sources: Centers for Disease Control and Prevention, National Center for Health Statistics

This second line of evidence comes from the National Vital Statistics System, which records birth and death certificates. Every time somebody dies, a death certificate is filed in the state where the death occurred. And after the records are registered at a state level, they are sent to the National Center for Health Statistics, which tracks deaths at a national level. Death certificates are not filed in the system until outstanding test results are in and the information is as complete as

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health

Covid-19 Live Updates: N.F.L. Team Thrown by False Positive Rapid Tests

Here’s what you need to know:

Credit…Jeff Haynes/Associated Press

The Indianapolis Colts on Friday briefly joined the growing group of N.F.L. teams dealing with a potential outbreak of coronavirus cases. Except hours later, the team announced that it had been wrong: The “four individuals” who had tested positive for the virus were re-tested and found to be negative.

Hours after the Colts said they were closing their practice facility, the New England Patriots — who had just emerged from a virus-inflicted week off — also called off their Friday session after recording at least one new positive. The Patriots said the team also was waiting for the results of a follow-up test for a second player to confirm whether he, too, was positive.

The confusion in Indianapolis, though, mirrored a similar series of events last Friday involving the Jets, who closed and then quickly reopened their training facility after an initial positive result was not confirmed in a second test. But the uncertainty and disruption also cast new doubt on the reliance on rapid testing to spot, and prevent, virus outbreaks as the league plows ahead with its schedule.

The rash of false positives echoed several other incidents that have made headlines in recent months. In August, Gov. Mike DeWine of Ohio tested positive on a rapid test, only to confirm thrice by a laboratory test that he did not have the coronavirus. And on Oct. 2, officials in Nevada issued a statewide directive to nursing homes to halt use of two government-issued rapid tests that had produced a concerning number of false positives that could not be confirmed by more accurate tests. Under pressure from the federal government, the state reversed the order a week later.

Although faster, more convenient, and cheaper than typical laboratory tests, rapid tests for the coronavirus are far less accurate. They more often miss cases of the coronavirus, as well as mistakenly label healthy people as infected.

Still, rapid tests make up a growing contingent of the testing landscape in the United States. In September, the White House announced detailed plans to ship 150 million rapid tests manufactured by Abbott Laboratories to governors and vulnerable communities around the nation.

Much of the scrutiny on rapid tests has focused on false negatives, which can hasten the spread of disease when cases are missed. But false positives can be damaging as well, keeping employees out of workplaces and triggering unnecessary anxiety.

In some cases, people who receive false positives may even be isolated with individuals who are actually harboring the virus, raising the risk of further spread.

The news of the new Patriots’ new case came a day after two of the team’s most important players, quarterback Cam Newton and cornerback Stephon Gilmore, returned to practice after a stay on the team’s reserve/Covid-19 list.

Newton, who joined the Patriots this season, and Gilmore, the reigning N.F.L. defensive player of the year, are expected

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