A 25-second video shows Dr. Seth Lookhart floating into an exam room. He appears to remove a tooth from a sedated patient, then pivots and rides away on a hoverboard, tossing his gloves in the air, removing his mask and flashing a smile at the camera. 

The video, which appears to have been shot on a cell phone, is now evidence in a criminal case against the Anchorage dentist. 

Lookhart, 34, is facing 42 charges — accused of Medicaid fraud and endangering his patients. According to court documents, Lookhart and his former office manager, Shauna Cranford, pushed Medicaid patients to undergo intravenous sedation needlessly in order to bill Medicaid for the service. 

They were both charged in April 2017. 

Rachel Miner, a former employee at Lookhart's practice, Clear Creek Dental, testified that patients were sedated for periods of time that exceeded the length of the procedure. 

"There was a start time and a stop time," she explained, "and Shauna had a chart on her computer, like an excel spreadsheet, and she'd calculate things on it and then the assistants, when the procedure was done, they'd go to Shauna to get the stop time."

Miner said that sometimes Lookhart would agree to provide service to Medicaid patients who had used up their benefits if they would undergo IV sedation. 

"If a patient was out of their Medicaid benefits, so they didn’t have anything available," Miner explained, "we would waive that fee and they could do it with sedation so there was still money coming in." 

Another employee testifying telephonically said it was not uncommon for a Medicaid patient to be under IV sedation for up to three hours for a procedure that should only take an hour. 

An information document filed in the case explains the significance of a three-hour window: 

"Generally speaking, IV sedation is the most costly form of anesthesia that can be billed to Medicaid. Currently, IV sedation is billed under the dental code D9243 and is paid at a rate of $170.76 for each 15 minute increment it is used, up to 12 units or 3 hours ($2,049.12). By comparison, nitrous oxide is currently paid at a flat rate of $57.01, oral sedation is paid at $188.12 and local anesthesia is generally included in the cost of a dental procedure when it is necessary." 

The same document details several text messages between Cranford and Lookhart, discussing targeting Medicaid patients for IV sedation. In one message, Lookart allegedly wrote:

"So let's build a practice around it, sedation, and let's medicaid it up"  

"The cost for the IV sedation is generally not included in the patient's $1,150 annual limit for non-emergency procedures. This practice quickly became very lucrative for Dr. Lookhart resulting in his practice alone being responsible for 31% of the total Medicaid payments for IV sedation in 2016." 

 

Dr. Seth Lookhart is seen in a video riding a hoverboard while performing a dental procedure. (Source: Alaska Court System)

While patients were under sedation, they were not always attended by someone qualified to assist them if there were complications, according to a former staff member. 

Kallie Wagner described being told she was responsible for a sedated patient as "terrifying." 

"Because that’s somebody’s life," she said, "and not like... there wasn’t anybody in the room properly trained enough or like a doctor in the room to... what if something bad happened?" 

Two patients testified that they woke up to mistakes and botched dental work that caused them pain and distress. 

"Where's my four teeth?" Joseph Smith asked Lookhart from the witness stand. 

Smith said he was told he would receive a partial denture to compliment four good teeth in the bottom of his mouth. When he went home, he realized the four healthy teeth had been removed and Lookhart had placed a poorly fitting full plate. 

"I would have died with them," he said. "I couldn't swallow. I couldn't eat. I couldn't talk. And they kept insisting, 'oh those are yours, they were made just for you.'" 

He referred to them in court as "cow teeth" and said it took months of continued appointments to get a new set of functional dentures.

"I was violated," Smith said. "I was mad because if there was a problem and you had to take them, why didn't he say something?" 

Another former patient, Nickolas Seifert, is still suffering. 

"I can't chew or eat. I don't really have any chewers in the back and my front teeth. My bottom teeth are destroying my front teeth because there's no stopper, if you will," he told the judge, later adding, "I don't look in the mirror anymore." 

He said Lookhart used up his Medicaid benefits making mistakes, on one occasion sedating him and working on the wrong tooth. 

The patients' testimony comes weeks into a lengthy bench trial. Anchorage Superior Court Judge Michael Wolverton will ultimately determine whether Lookhart is guilty or innocent. 

According to online court records, Cranford accepted a plea deal in October. Her sentencing is scheduled for February.

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