Conspiracy to Commit Healthcare Fraud: A Dentist's Case

What happens after you plead guilty to conspiracy to commit healthcare fraud?

United States of America versus Richard Nate Schott.

Dr. Nate Schott read that caption with his own name on the wrong side of it. He had built a dental organization in Tennessee that served about 50,000 patients a year.

"It's not just like there's an elephant on your chest. It truly is, in my opinion, the greatest superpower of the world versus one person."

He coached other dental professionals and did missionary work. By the time he learned he was a target, the government had been investigating him for three years.

His practice had billed for services that weren't delivered as documented. He pleaded guilty to one count of conspiracy to commit healthcare fraud. Then he had seven months until sentencing.

If you are a licensed professional in those months now, this case is about who will read about you, and what each of them will find.

The first reader is you

Nate described depression, anxiety, and hypervigilance after he learned about the case. Professionals rarely say that out loud. They treat it as a weakness to push through.

I referred Nate to a mental health professional who knew the criminal justice system. A defendant who can't sleep and can't think straight can't do any of the work that follows.

If you have stopped sleeping, tell someone this week. Tell your doctor, a counselor, or your lawyer. You can't prepare for the probation officer while you are reading the case caption at 3 a.m.

The people who remember you

Our team interviewed Nate's relatives and colleagues. We asked them what they remembered: a specific day, a specific patient, a specific moment. Their character letters were built around those incidents.

The people who write your letters have known you longer than the government has. Ask each one for one story they were present for. A dozen letters calling you a dedicated professional say the same thing a dozen times. One letter about the Saturday you came in for a patient who couldn't pay says something only that writer can.

The probation officer

Nate understood something many defendants learn too late:

"The probation officer is going to be the one going before that judge with what you had. And they have so much sway."

He brought a written narrative to his presentence interview. It covered his childhood, his career, his substance use history, and the decisions that led to the offense. His defense attorneys reviewed his preparation and handled every legal submission.

He went in with a clear purpose:

"I wasn't going in to plead my case. I was going in to show who I was and how I had remorse."

Professionals walk into that interview ready to explain billing codes and compliance systems. The officer has the government's file on that already. What the officer doesn't have is the rest of your life. Bring it on paper.

The substance use history mattered for a second reason. If alcohol or drugs are part of your story, the presentence report is where that history gets documented. Nate worked on documenting his before the interview, and it went into the record the Bureau of Prisons would later read.

The judge

Prosecutors asked for 51 months. Nate's attorneys asked for 18. The judge imposed 33.

Some time later, Nate ran into the judge in an airport. By Nate's account, the judge remembered him and said:

"I really believed you. You had a good story. I felt it was true and it reflected who you were."

What the judge remembered, far from the courtroom, was whether Nate had told him the truth.

The Bureau of Prisons

Nate learned how the Bureau of Prisons' Residential Drug Abuse Program works before he surrendered. He reported early acceptance into RDAP and completed it. He served ten months of his 33-month sentence.

In his April 6, 2022 Trustpilot review, he wrote:

"I firmly believe I served a 10-month sentence because of the professional preparation that Justin and his team provided."

While he was inside, I stayed in touch with his wife. Your family is serving part of this sentence too. Decide now who they will call when they have questions you can't answer from a prison phone.

The licensing board

Nate lost his dental license after his conviction. He moved into dental consulting and education, and he has described plans to apply for reinstatement.

If you hold a professional license, it is on the line along with your freedom. The board will eventually read about this case too. Ask your attorney what your conviction means for your license in your state, and start keeping the record a board will want to see years from now.

Nate talked through the whole experience with me on camera: watch the conversation.

Questions professionals ask about healthcare fraud charges

What is conspiracy to commit healthcare fraud? An agreement with at least one other person to commit a healthcare fraud offense. The exact elements depend on the statute charged and the facts. Nate pleaded guilty to one count in Tennessee.

How are healthcare fraud sentences calculated? Under the fraud guideline, loss amount drives most of the range, and federal healthcare offenses carry an added enhancement when the loss to a government program is large. The judge then weighs the factors in 18 U.S.C. § 3553(a), including your history and characteristics.

What happens to my license and my ability to bill? It depends on your state and profession. A conviction can lead to license discipline or revocation, and to exclusion from federal healthcare programs. Ask your attorney before you plead.

Can RDAP reduce my time in prison? Eligible people who complete RDAP may qualify for a reduction under Bureau of Prisons rules. Eligibility depends in part on documented substance use history.

Can a consultant reduce my sentence? No one can promise a sentence. Your lawyers argue the case and the judge decides it. What you control is what each reader finds when they open your file.

This week, ask your attorney two questions: when will probation interview me, and what will my licensing board receive about this case? Bring both answers to a $500 diagnostic call with me, and we'll start with whoever reads about you first.

Thank you,

Justin Paperny