NEW HAVEN – Two Norwalk dental providers have entered into $600,000 in civil settlement agreements with federal and state authorities to resolve allegations of Medicaid fraud, according to the U.S. Attorney’s Office for the District of Connecticut.
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.
To resolve the allegations under the federal and state False Claims Acts, Advanced Dental Center PC of Norwalk and its owners Tal Yossefi, DMD and Elad Yossefi paid $495,721.24 to reimburse the Medicaid program for conduct occurring from July 1, 2018, through Dec. 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.
The U.S. Attorney and state Attorney General offices claim that Advanced Dental Center PC of Norwalk and its owners submitted claims to the CTMAP, which includes the state’s Medicaid program, related to dental services rendered to 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, according to the government. With each submitted claim, Advanced Dental Center and its owners 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).
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.
This investigation was conducted by the FBI; 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.
