Mira Mesa dentist sentenced to 6 years in custody for $866K insurance fraud scheme

A Mira Mesa dentist was sentenced Wednesday to six years in custody and ordered her to pay more than $405,000 in restitution for fraudulently billing 10 insurance companies for hundreds of root canals she did not perform, authorities said.

April Rose Ambrosio, 59, pleaded guilty earlier this year to three counts of insurance fraud as part of a four-year scheme in which she billed the insurance companies $866,700, according to prosecutors and the state insurance commissioner.

Authorities said she was paid $405,633 by the insurance companies. San Diego Superior Court Judge Daniel Goldstein ordered Ambrosio to pay back that money.

She was ordered to serve a split sentence, meaning she will spend three years in county jail and three years on mandatory supervision in the community. California law changed in 2011 to allow some non-violent offenders to serve their prison terms in jail — a situation often described in court as “local prison.”

In September 2019, a judge ordered Ambrosio to stop practicing dentistry. State records show that’s when her license, which was issued in 1990, was suspended.

Authorities said Ambrosio falsely claimed to have performed 800 root canals on 100 patients between 2014 and 2018, even though she lacked the specialized training required to perform root canals.

In some instances, the people she claimed to have performed root canals for had never set foot in her office. In another instance, she billed an insurance company $61,700 for 110 root canals, all of which she claimed to perform on a family of four over just a three-month period in 2016.

“Her deception involved billing for work on days her office was closed, or she was noted as being on vacation,” county prosecutors said in a news release. “In some instances, Ambrosio billed for root canals on non-existent or missing teeth, or she double billed for teeth she previously claimed to have performed root canals on.”

San Diego County District Attorney Summer Stephan said the way that Ambrosio “bilked the system” was “astounding.”

“Unfortunately, when insurance companies get ripped off, consumers ultimately pay the price through higher premiums,” Stephan said in a news release.

Ambrosio’s attorney, Kerry Armstrong, said his client “is extremely remorseful” and ready to begin her sentence next week.

“By all accounts, she was a fantastic dentist to her patients,” Armstrong wrote in an email Wednesday night. “And while she possibly will never get to practice dentistry again, she hopes to work in a field where she can help people once she serves her sentence and regains employment again.”

California Department of Insurance personnel investigated Ambrosio for more than two years and worked with the insurance fraud division of the District Attorney’s Office to prosecute the case.

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Under 60% of English COVID contacts reached in new record low for trace scheme

LONDON (Reuters) – A record low 59.6% of contacts of positive COVID cases were reached in the latest week, statistics for England’s Test and Trace scheme showed on Thursday, with turnaround times for people receiving their results also getting slower.

British government scientists have warned that the test and trace scheme is relatively ineffective as the coronavirus spreads ever more quickly, and Prime Minister Boris Johnson is tackling a growing second wave with a localised approach.

Recent weeks have seen increases in the number of contacts of positive COVID-19 cases identified, with 251,613 identified in the latest week, up 15% on the previous week.

But the proportion being contacted is well below an 80% target for contacts traced.

Between Oct. 8 and Oct. 14, 33.4% of in-person test results were received the day after the test was taken, compared with 67.9% the week before.

The test and trace scheme showed that there had been a 12% increase in positive cases in the latest week. There were 96,521 people transferred to the system, of which 80.7% were reached and asked to provide information about their contacts.

(Reporting by Alistair Smout, editing by Elizabeth Piper and Stephen Addison)

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