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Insurance Claims professional presents articles and videos on insurance, insurance Claims and insurance law for insurance Claims adjusters, insurance professionals and insurance lawyers who wish to improve their skills and knowledge. Presented by an internationally recognized expert and author.
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June 06, 2024

Chutzpah From Convicted Dentist

Read the full article at https://lnkd.in/gF7fG4Mj; sd at https://lnkd.in/g6DBszdk and at https://zalma.com/blog plus more than 4800 posts.

Post 4817

THE LICENSE REVOCATION

The Board of Dental Examiners revoked Seth Lookhart’s dental license after he was convicted of dozens of crimes perpetrated in furtherance of a fraudulent scheme of staggering proportions that jeopardized the health and safety of his patients. Lookhart appealed the Board’s revocation of his license, arguing that his punishment was inconsistent with past Board decisions. On appeal, the superior court concluded that the Board properly exercised its discretion by revoking Lookhart’s dental license.

In a case of Chutzpah (unmitigated gall) called Seth Lookhart v. State Of Alaska, Division Of Corporations, Business, & Professional Licensing, Board Of Dental Examiners, No. S-18466, No. 7702, Supreme Court of Alaska (May 24, 2024) he asked for his license to practice dentistry from jail, the time of the Supreme Court was wasted as it resolved the issues raised by Lookhart.
FACTS AND PROCEEDINGS

Seth Lookhart was issued an Alaska dental license in June 2014 and a parenteral sedation permit in May 2015. Between May 2016 and March 2017, Lookhart systematically and unnecessarily sedated his patients in a manner that allowed him to fraudulently bill the maximum amount covered by Alaska’s Medicaid program, overcharging Medicaid by more than $1.6 million. Lookhart routinely billed Medicaid for sedation that was not performed, billed Medicaid at higher rates than other insurers, and created false dates of service to maximize his wrongful reimbursements. During this same period Lookhart also stole an additional $412,500 from a business partner.

In order to maximize his billings to Medicaid, Lookhart engaged in a series of standard-of-care violations: He sedated patients beyond the scope of his training and permit, sedated multiple patients simultaneously, billed Medicaid for sedation during routine cleanings, and sedated patients with underlying chronic diseases that made sedation dangerous. He allowed his unlicensed office manager to sedate patients, pressured patients into unwanted sedation, and left sedated patients to drive themselves home.

On two occasions, Lookhart’s patients nearly lost their lives as a direct consequence of his reckless sedation practices. Lookhart also extracted one deeply sedated patient’s tooth while riding a hoverboard, and then sent a video of the unsafe extraction to his friends and family members without the patient’s consent.

After a six-week bench trial ending in January 2020, he was convicted on 46 charges, including 11 felony counts of medical assistance fraud, three felony counts of scheming to defraud, one count of felony theft. The trial court also issued an order finding that the State had proven 13 sentencing aggravators beyond a reasonable doubt. The trial court found that the evidence against Lookhart was “overwhelming.” He was ultimately sentenced to 20 years in prison with eight years suspended.
Dental Board Proceedings

Following Lookhart’s convictions, the Division of Corporations, Business and Professional Licensing filed a 17-count accusation seeking to revoke Lookhart’s dental license. Lookhart stipulated to the facts contained in the accusation, leaving it to an administrative law judge (ALJ).

The ALJ concluded that Lookhart’s “astonishing range of misconduct” was “more wide-ranging and severe” than in any prior case in which the Board imposed a lesser sanction. Taken as a whole, the ALJ concluded that revocation was the “clear and obvious sanction,” adopting the Division’s contention that, “[i]f this case does not require it, no future case will.”
The Superior Court’s Decision

The trial court noted that “no Alaska case is factually comparable to the sheer scale of malfeasance here,” that the Board “painstakingly detailed” Lookhart’s misconduct, and that it had “carefully considered and rejected any comparison with prior Board cases.”
DISCUSSION

As relevant to this case the statute which provides for license revocation in cases of fraud and providing the same for standard-of-care violations, would be rendered meaningless.
No Prior Dental Board Decision Involves Similar Facts.

Lookhart stole millions of dollars from the state program that provides medical care for the indigent, while simultaneously defrauding a business partner of several hundred thousand more, and committing an egregious string of standard-of-care violations that not only jeopardized the safety, privacy, and autonomy of his patients, but also brought the dental profession into disrepute.

Lookhart stole millions of dollars from Medicaid. In furtherance of this massive fraud, he repeatedly subjected his patients to great risk of harm. There are no cases in the Board’s history comparable to Lookhart’s.

The Supreme Court concluded that the Board did not abuse its discretion by revoking Lookhart’s license. None of the Board’s prior licensing cases involved misconduct of the scope and severity in this case, so there was no applicable precedent to limit the Board’s exercise of its discretion.

ZALMA OPINION

“Chutzpah” is a Yiddish word for unmitigated gall usually explained as a person convicted of murdering his parents who asks for clemency because he is an orphan. Lookhart, a dentist about to serve 20 years in state prison had the chutzpah to demand his license to practice dentistry reinstated. The Supreme Court gave his claim short-shrift and by doing so protected his fellow prisoners from being treated by a vicious person who almost killed a patient while extracting a tooth balancing on a hoverboard and stealing from Medicaid.

(c) 2024 Barry Zalma & ClaimSchool, Inc.

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© 2025 Barry Zalma, Esq., CFE

When I finished my three year enlistment in the US Army as a Special Agent of US Army Intelligence in 1967, I sought employment where I could use the investigative skills I learned in the Army. After some searching I was hired as a claims trainee by the Fireman’s Fund American Insurance Company. For five years, while attending law school at night while working full time as an insurance adjuster I became familiar with every aspect of the commercial insurance industry.

On January 2, 1972 I was admitted to the California Bar. I practiced law, specializing in insurance claims, insurance coverage and defense of claims against people insured and defense of insurance companies sued for breach of contract and breach of the implied covenant of good faith and fair dealing. After 45 years as an active lawyer, I asked that my license to practice law be declared inactive ...

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