Somers Resident Enters Guilty Plea In Insurance Fraud Case

SOMERS, CT — A Somers man accused of altering medical claims has entered a plea in his federal case.

Vanessa Roberts Avery, United States attorney for the District of Connecticut, Phillip M. Coyne, special agent in charge of the U.S. Department of Health and Human Services and Robert Fuller, special agent in charge of the New Haven Division of the Federal Bureau of Investigation announced Wednesday that Dennis Tomczak, 73 , of Somers, has entered a guilty plea in federal court to a false statement offense stemming from his role in a Medicaid fraud scheme.

According to court documents and statements made in court, Tomczak, a state-licensed alcohol and drug abuse counselor, offered substance abuse treatment and related counseling services through his business, Pathway to Peace, LLC.

Tomczak accepted Medicaid insurance and cash payments for his services, according to case records.

In 2019, a medical provider asked Tomczak to use his own provider number to bill Medicaid for patients that the provider was supposedly seeing for psychotherapy sessions, Avery said. In exchange, Tomczak would retain 25 percent of the Medicaid claims paid and he would turn over 75 percent of the payments to the provider, according to case records.

Tomczak agreed to do so, and from approximately April 2019 through October 2022, based upon a spreadsheet provided to him by the provider, Tomczak billed Medicaid for psychotherapy and related services supposedly rendered by the provider as if Tomczak had personally rendered those services himself, according to case records.

Tomczak never met any of the provider’s clients and did not review records and treatment notes for any services "allegedly" rendered by the provider, Avery said.

Through the scheme, Medicaid paid Tomczak approximately $338,427.11 for approximately 53 clients that the provider had "allegedly" treated, Avery said.

Per his agreement with the provider, Tomczak retained approximately $84,000 of the claims money received from Medicaid, Avery said.

On Aug. 21, Tomczak waived his right to be indicted and pleaded guilty before U.S. District Judge Kari A. Dooley in Bridgeport to one count of making a false statement relating to a health care matter, an offense that carries a maximum term of imprisonment of five years. Judge Dooley scheduled sentencing for Nov. 13.

Tomczak is released on bond pending sentencing.