Dentist cops to conspiring to commit $8M in fraud

A dentist in California pleaded guilty on October 4 in U.S. court to conspiring to commit healthcare fraud by billing Medicare for about $8 million worth of procedures that were not performed or needed, according to the U.S. Department of Justice.

Dr. Javad Aghaloo, 50, of Javad Aghaloo, DDS in El Centro, CA, also agreed to forfeit more than $1 million in property and pay restitution to Medicare in the amount of $8,476,466.23. His office manager, Theresa Flores, 45, pleaded guilty to obstructing a Medicare audit, according to a press release dated October 4 from the U.S. Attorney’s Office for the Southern District of California.

Aghaloo and Flores, both of San Diego, CA, will be sentenced in January. Each faces a maximum sentence of up to five years in prison and a fine of $250,000. 

To recruit Medicare patients, Aghaloo and Flores are accused of marketing dental services, claiming they were covered by Medicare, though they knew that Medicare did not cover dental services, according to the release. Once a Medicare beneficiary went to one of the dentist’s offices, Aghaloo and others purportedly performed a procedure, often a tooth extraction, and submitted false claims to Medicare. Since tooth extractions are not covered by Medicare, Aghaloo’s offices allegedly submitted false claims for procedures like bone grafts that were never performed, according to the release.

Between March 2016 and October 2018, Aghaloo and Flores allegedly submitted more than 7,000 false claims to Medicare, totaling more than $18 million. Medicare reimbursed Aghaloo’s offices for $8,476,466.23, according to the release.