A patient for whom jailed Tipperary dentist Jerome Kiely claimed payment for 19 extractions told dental inspectors she only attended him to receive new upper and lower dentures.
Kiely also claimed for 32 extractions in relation to another patient who told the inspectors she had no top teeth, and just three bottom teeth, when she went to him. Kiely extracted one of the remaining three, she said.
The patients are among many referred to in a report by the HSE dental inspectorate that concluded Kiely had falsely claimed payments from the HSE for treatments he never provided, including many extractions previously carried out by other dentists.
This was the explanation for data showing Kiely’s patients were “having teeth filled and teeth extracted at rates far above the national norm”, the December 2019 report, authored by Joe Mullen, chief dental inspector with the HSE’s Primary Care Reimbursement Service, said.
READ MORE
People “generally remember getting their teeth extracted” but a review of 302 ordinary extractions claimed for by Kiely between 2014 and 2019, at €39.50 each, could not confirm he carried out 252 of those, the report stated.
Kiely qualified as a dentist in 2003 and established his own practice in Tipperary town in 2006.
In 2019, the dental inspectorate sought to review some of his patients on foot of issues raised by staff at the dental unit of the HSE’s Primary Care Reimbursement Service.
As part of that review, the inspectors advised Kiely they had arranged an assessment clinic in May 2019 with some patients whose records they had reviewed.
Of 57 patients invited, just eight attended, of whom two said they had been advised by Kiely they were not obliged to attend. One patient said he was phoned three times by Kiely urging him not to attend.
[ Dentist who defrauded HSE over 17 years is jailed and ordered to pay €100,000Opens in new window ]
A further clinic was organised in July 2019 of which Kiely was not made aware, and 47 patients attended.
The inspectors’ report was later referred to the Garda National Economic Crime Bureau, sparking an investigation that ultimately resulted in Kiely’s prosecution.
A married father of three, Kiely (47), of Monard, Co Tipperary, pleaded guilty at Dublin Circuit Criminal Court last November to one sample count of dishonestly inducing the HSE to provide a payment of €326 for dentures on May 12th, 2015.
He was originally charged with 32 counts of deception but, when arraigned last month, pleaded guilty to six further sample counts on dates between November 2010 and September 2019.
He was separately sent forward to the Circuit Court on signed pleas from the District Court on 47 charges of deception between May 2008 and January 2025. Two bank accounts belonging to him containing about €830,000 and €667,000 were frozen.
Last week, Kiely was jailed by Judge Martin Nolan for one year for defrauding the HSE of €58,000 over a 17-year period and ordered to pay €100,000 to the HSE.
The HSE had placed its trust in Kiely as a dentist; this trust turned out to be “misplaced” and the court had to accept Kiely “knew what he was doing was wrong”, the judge said.
In their review, the dental inspectors noted a “pattern” of Kiely making false claims for historical extractions when examining a patient for the first time under the Dental Treatment Services Scheme, which allows adult medical card holders to access dentists for care and appliances including fillings, extractions, root canals and dentures.
The report said Kiely had claimed multiple extractions for patients who had requested new dentures, some of whom had their teeth extracted years before, and claimed for restorations and dentures that were not provided.
A patient for whom Kiely claimed payment for 15 extractions on one day in 2018 told inspectors he had an appointment for one extraction in 2019, leaving 14 extractions unconfirmed.
A woman for whom Kiely claimed 12 extractions on dates in 2018 and 2019 said she had just one extraction carried out by him in 2019; the other teeth were extracted some time earlier in Poland.
The report said Kiely’s reimbursement claims were “significantly higher” than the national average for ordinary extractions, surgical extractions, amalgam fillings and composite fillings and showed “an unusual distribution of treatments” for dentures.
There is no restriction on the number of ordinary extractions, carried out under local anaesthetic, that may be carried out in a course of treatment, it noted.
A review of 302 ordinary extractions (at €39.50 each) claimed for by Kiely could not confirm he carried out 252 of those and he was a “significant outlier” from the norm regarding surgical extraction claims at €70 each.
Data showed his deviation from the standard mean for surgical extractions was higher than 99 per cent of all dental contractors.
Surgical extractions, intended to deal with removal of buried teeth and other difficult cases, were likely to be “quite a memorable event” for a patient as they involved significant invasion of the tissue. A patient was “very likely” to recall a “highly unusual” treatment such as surgical flap creation and having to carry around sutures in their mouth for a week.
Of 24 claims for surgical extractions reviewed at a patient examination clinic in 2019, 17 could not be verified by Kiely’s patients, the report said.
The inspectors found the patients’ recollections were consistent and concluded Kiely had claimed €70 for surgical extractions when a fee of €39.50 was appropriate. The evidence suggested the majority of the extractions claimed at the higher fee should have been claimed at the lower fee, the report said.
There was also evidence Kiely consistently claimed fees for providing two single sets of dentures when a single full set was actually supplied, the report said. He claimed a total of €652.44 for separate upper and lower dentures instead of €478.74 for a single set of full dentures, with the effect he was paid an additional €173.70 per patient.
Kiely had made a large number of applications to the Primary Care Reimbursement Service to alter claims he had previously made and also offered to refund the HSE, the report noted.
At the date of the report, Kiely had stated claims by him to the amount of €17,097 were invalid for various reasons. Due to the unreliability of the records received from him, the report said it was “not possible” to estimate liability.
It concluded further investigation may require referral to “another body” and there were grounds for “very serious concern” regarding Kiely’s claiming patterns.
In court last week, Nolan accepted psychiatric evidence Kiely had mental health problems and a lengthy history of depression. It was questionable whether Kiely would be able to practise as a dentist again, the judge added. “His reputation has been destroyed.”
Nolan said: “He is a very intelligent and accomplished man. The court is at a loss as to why he did it. It seems he had plenty of money.”
