CT Dentists Pay $498K To Settle False Claims Allegations: Feds

WATERBURY, CT — Two dentists and their respective Waterbury and New Britain businesses accused of violating federal and state False Claims Acts have entered into a civil settlement agreement and will pay more than $498,000, U.S. Attorney Vanessa Roberts Avery and Connecticut Attorney General William Tong said in a news release Monday.

Bohun Choi and Michong Son are both licensed to practice dentistry in Connecticut.

Choi, Son and their businesses, C&S Family Dental New Britain and C&S Family Dental Waterbury, are enrolled as dental providers in the Connecticut Medical Assistance Program, "CTMAP," which includes the state's Medicaid program, Avery and Tong said.

According to Avery and Tong, in violation of their CTMAP provider agreements and the federal Anti-Kickback Statute, both dentists and their businesses submitted claims to the CTMAP related to dental services rendered to Connecticut Medicaid patients referred to C&S New Britain and C&S Waterbury by a third-party "patient recruiting" company.

Federal and state government officials accuse Choi, Son and their businesses of paying a patient recruiter $110 for each Connecticut Medicaid patient the recruiter referred to them whenever the patient received services over and above routine preventative care, such as dental cleanings and exams, and submitted claims for dental services rendered to those patients, according to Avery and Tong.

With each submitted claim, they "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...provider manual concerning the submitted claim," the release reads.

According to Avery and Tong, 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, both dentists and their businesses agreed to pay $498,310 to reimburse the Medicaid program for conduct occurring from April 1, 2018, through Jan. 12, 2020, according to Avery and Tong.

Under the False Claims Act, the government can recover up to three times its actual damages plus penalties of $13,946 to $27,894 for each false claim, Avery and Tong said.

People who suspect health care fraud are encouraged to report it by calling 1-800-HHS-TIPS.