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. It is alleged that, in violation of their Connecticut Medical Assistance Program (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.