Two dental providers in Connecticut have agreed to civil settlements with federal and state governments over allegations of violating the False Claims Acts. The settlements are part of a broader investigation into fraudulent activities by healthcare providers who allegedly submitted kickback-tainted claims to the Connecticut Medical Assistance Program (CTMAP) for services provided to Medicaid patients referred by third-party recruiting companies.
The allegations claim that Advanced Dental Center PC, based in Norwalk, along with its owners Tal Yossefi, DMD, and Elad Yossefi, DDS, violated their CTMAP provider agreements and the federal Anti-Kickback Statute. They allegedly submitted claims related to dental services rendered to Medicaid patients referred by a third-party recruiter. Advanced Dental Center is said to have paid a recruiter for each Medicaid patient referred. By submitting these claims, the practice and its owners impliedly certified compliance with payment conditions, including not paying kickbacks or violating terms of the Connecticut Dental Health Partnership (CTDHP) provider manual.
The CTDHP manual explicitly prohibits per-patient compensation for referrals made to CMAP providers.
To resolve these allegations under the False Claims Acts, Advanced Dental Center and the Yossefis reimbursed $495,721.24 for conduct from July 1, 2018, through December 31, 2018.
Additionally, Nazneen Jaffri, DDS—a former dental provider in Connecticut—agreed to reimburse $150,000 for conduct from January 1, 2019, through April 24, 2021. She faced allegations of submitting or causing false claims submission to CTMAP for services rendered to Medicaid patients referred by a third-party recruiter.
In agreeing to these settlements, neither the providers nor their practices admitted liability.
The investigation was carried out by several agencies: the Federal Bureau of Investigation; U.S. Department of Health and Human Services' Office of Inspector General; Connecticut Attorney General’s Office; and Connecticut Department of Social Services. The case was prosecuted by Assistant U.S. Attorney Anne Thidemann and Assistant Attorney General Joshua L. Jackson from the Connecticut Office of the Attorney General.
Individuals suspecting healthcare fraud are urged to report it at 1-800-HHS-TIPS.