Norwalk Dentists Pay More than $600K to Settle False Claims Allegations

Two Connecticut dental providers have entered into civil settlement agreements with the federal and state governments to resolve allegations of violations of the federal and state False Claims Acts. The settlements stem from a larger investigation into fraudulent activity by health care providers who submit kickback-tainted claims to the Connecticut Medical Assistance Program ("CTMAP") for services rendered to Connecticut Medicaid patients referred by third-party "patient recruiting" companies.

It is alleged that, in violation of their CTMAP provider agreements and the federal Anti-Kickback Statute, Advanced Dental Center PC, a dental practice based in Norwalk, and its owners, Tal Yossefi, DMD and Elad Yossefi, DDS, submitted claims to the CTMAP, which includes the state's Medicaid program, related to dental services rendered to Connecticut Medicaid patients referred to the business by a third-party patient recruiting company. Advanced Dental Center paid a patient recruiter for each Connecticut Medicaid patient the recruiter referred to the practice. With each submitted claim, Advanced Dental Center and its owners impliedly certified that the conditions of receiving payment were met, including, but not limited to, that they did not pay kickbacks or violate any terms or provisions of the Connecticut Dental Health Partnership ("CTDHP") provider manual concerning the submitted claim.

The CTDHP provider manual, which is an addendum to both the CTMAP provider agreement and the CTMAP provider manual, expressly prohibits per-patient compensation for individuals referred to CMAP providers.

To resolve the allegations under the federal and state False Claims Acts, Advanced Dental Center and the Yossefis paid $495,721.24 to reimburse the Medicaid program for conduct occurring from July 1, 2018, through December 31, 2018.

In addition, Nazneen Jaffri, DDS, a dental provider formerly licensed in Connecticut who operated a practice in Norwalk, agreed to reimburse the Medicaid program $150,000 for conduct occurring from January 1, 2019, through April 24, 2021, to resolve allegations that she violated the False Claims Act by submitting or causing to be submitted claims to the CTMAP for dental services rendered to Connecticut Medicaid patients referred to her business by a third-party patient recruiting company.

In entering into their respective civil settlement agreements, the providers and their practices did not admit liability.

This investigation was conducted by the Federal Bureau of Investigation; the U.S. Department of Health and Human Services, Office of the Inspector General; the Connecticut Attorney General's Office; and the Connecticut Department of Social Services. The case was prosecuted by Assistant U.S. Attorney Anne Thidemann and Assistant Attorney General Joshua L. Jackson of the Connecticut Office of the Attorney General.

People who suspect health care fraud are encouraged to report it by calling 1-800-HHS-TIPS.