California Attorney General Rob Bonta announced the sentencing of a Southern California dentist, along with two employees of her dental practice, for their fraudulent billing scheme that defrauded the state Medi-Cal program of nearly $800,000. Dr. Magaly Mercedes Velasquez and her spouse, Maria Jose Talavera, who served as an office manager, were sentenced by the Riverside County Superior Court to 364 days in jail and ordered to pay restitution in the amount of $770,238 to Medi-Cal. Jessica Monique Perez, the billing manager, will be placed on probation for two years. The prosecution in this case was carried out by the California Department of Justice’s Division of Medi-Cal Fraud and Elder Abuse (DMFEA).
“When dentists like Velasquez defraud Medi-Cal to line their own pockets, they jeopardize the program’s ability to provide necessary healthcare services to our most vulnerable patients,” said Attorney General Bonta. “Today’s sentencing holds Velasquez and others involved in this fraudulent billing scheme accountable and sends a strong message: The California Department of Justice is committed to safeguarding California’s communities and public programs and will not tolerate crimes against them.”
Velasquez owned the U-First Dental practice where she served as a dentist and carried out the fraudulent billing scheme from January 1, 2017 to December 31, 2019. Contracted with Borrego Community Health Foundation, a Federally Qualified Health Center that participates in Medi-Cal, Velasquez received reimbursement for each day of service billed rather than for the individual services provided to the patient. However, U-First Dental fraudulently split their services over multiple days on their claims for reimbursement in order to maximize reimbursement from Medi-Cal.
DMFEA protects Californians by investigating and prosecuting those who defraud the Medi-Cal program as well as those who commit elder abuse. These settlements are made possible only through the coordination and collaboration of governmental agencies, as well as the critical help from whistleblowers who report incidences of abuse or Medi-Cal fraud at oag.ca.gov/dmfea/reporting.
DMFEA receives 75% of its funding from HHS-OIG under a grant award totaling $87,038,485 for federal fiscal year 2024. The remaining 25% is funded by the State of California. The federal fiscal year is defined as October 1, 2023 through September 30, 2024.
A copy of the sentencing minute order will be available in the coming days.
Original source can be found here.