This morning, the Attorney General’s Office (AGO) announced its fourth settlement from an ongoing joint investigation into the problem of Medicaid referral kickbacks, a scheme in which healthcare providers pay third parties to refer them Medicaid patients. Today’s settlement was to the tune of $495,721 and was entered into by Advanced Dental Center PC, a Norwalk-based dental office owned by Tal and Elad Yossefi.
“Paying kickbacks for patient recruitment is illegal,” said Attorney General William Tong. “Dentists participating in Connecticut’s public healthcare programs are responsible for knowing the law.”
Per the AGO’s release, Advanced Dental is enrolled in the Connecticut Medical Assistance Program (CMAP), a program overseen by the State’s Department of Social Services through which it administers the state’s Medicaid plans. Advanced Dental was alleged to have paid a “patient recruiting company,” or a third-party company that makes money off of provider kickbacks for Medicaid patient referrals, from the period of July 1 to December 1, 2018. Advanced Dental allegedly paid the company $120 per patient referred to them whose services exceeded preventative care, thus exceeding their $1,000 annual Medicaid benefit.
Paying kickbacks for Medicaid patient referral is strictly prohibited under federal anti-kickback statutes, as well as the CMAP provider agreement and the Connecticut Dental Health Partnership Manual. Per federal anti-kickback laws, those found guilty can be charged up to “$50,000 per kickback plus three times the amount of the remuneration.” Furthermore, the kickback statutes contain whistleblower provisions that entitle private citizens who report such schemes to a portion of the proceeds if a case is won.
“This is the fourth settlement arising from ongoing joint investigations, and we will continue to work closely with our state and federal partners to aggressively protect the integrity of our public healthcare programs,” said Tong.
In January, a New Haven-based dentist entered a $600,000 settlement with the state over alleged participation in a patient-referral scheme, and in August of last year, two other dentists entered a settlement for $1.7 million. All settlements were pursued by the AGO in conjunction with the U.S. Attorney’s Office, the federal Department of Health and Human Services’ Office of Inspector General and the FBI.
The issue of paid referrals in the medical industry extends beyond the school of dentistry as well; last October, the state netted $277,780 in restitution from opting into a joint settlement with Precision Diagnostics, a nationwide toxicology lab accused of charging medically unnecessary tests to Medicaid in addition to taking part in a kickback scheme.
The AGO’s statement urged anyone with knowledge of suspected fraud or abuse pertaining to public healthcare to contact the Attorney General’s Government Fraud Section, the state’s Medicaid Fraud Control Unit, or the state’s Department of Social Services’ fraud reporting hotline.
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