California dentist, office manager plead guilty to $8.5M Medicare fraud scheme

Javad Aghaloo, DDS, a dentist in San Diego, and Theresa Flores, his practice manager, pleaded guilty to Medicare fraud. 

Between March 1, 2016, and October 18, 2018, Dr. Aghaloo and Ms. Flores submitted over 7,000 false claims to Medicare totaling over $18 million. Dr. Agahaloo's offices were paid nearly $8.48 million for the claims by Medicare, according to an Oct. 4 news release from the U.S. Attorney's Office. 

Dr. Aghaloo and Ms. Flores would recruit Medicare patients in the area by marketing dental services, claiming they were covered by Medicare. Once the individual was at an office, a dental procedure such as a tooth extraction was performed, which is not covered by Medicare. The office would then submit a Medicare claim for other procedures that were never performed. 

To cover up the fraudulent claims, false documents were submitted to a federal auditor of the Medicare program between April 2017 and October 2018. 

Dr. Aghaloo entered a guilty plea, forfeiting more than $1 million in property and $8,476,466.23 in restitution to Medicare. 

The charges of conspiracy to commit healthcare fraud and obstructing a federal audit both have a maximum penalty of five years in prison and a fine of $250,000, the release said.

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