A California dentist has been accused of Medicare fraud after allegedly taking advantage of patients and billing for unperformed services.

On Apr. 26, the U.S. Attorney General filed a complaint against Dr. Javad S. Aghaloo of Southwest Dental Group arguing that his office had wrongfully billed patients for services that had not been performed. Aghaloo’s office reportedly billed nearly $16 million in services over just two years, some of which may have counted towards Medicare fraud.

As a result of the Medicare fraud claims against Southwest Dental Group, the U.S. Attorney’s Office has reportedly seized two bank accounts from Aghaloo which are valued at nearly $1.5 million. The office reportedly also seized a 2017 BMW M6 from Aghaloo which is valued at over $135,000.

Aghaloo’s office may have also convinced patients to undergo unnecessary services, but they may not be the only dental office in the area to do so. Patients told local news source KSWT that they experienced coercion and unnecessary procedures at the hands of other dentists in the same area as Southwest Dental Group.

Local customer Martina told reporters that her 80 year old father was taken advantage of by another dental office in the area when the dentist convinced him to have more teeth removed than necessary.

“I didn’t understand why my father came into the dentist and had all of his teeth pulled when he just needed one tooth,” Martina told KSWT. “Because of his age, because of his hearing and because of my father’s a diabetic and he’s also hard of hearing and I still – everywhere you go people take advantage of them.”

Another patient, Lucero, told reporters that she barely escaped a costly procedure after being taken advantage of at a local dentist office.

“I had some pain in my tooth. And I was, okay it’s a cavity. I need to get it filled and we fix it and we’re good to go. So, I got there…oh, you need a root canal asap! They gave me a big estimate about it and they gave me an estimate of a crown,” Lucero reported.

The complaint against Aghaloo reportedly references similar patient experiences.

According to Wikipedia, when a doctor, hospital, pharmacy, or other professional defrauds a government program like Medicare, Medicaid, or Tricare, they aim to collect money from the programs that they may not be owed. This can be done through a variety of strategies including:

• Phantom billing: medical providers billing Medicare for procedures and services that are not performed or are not necessary;
• Patient billing: patients providing their Medicare information to providers which will then use that information to commit fraud; these patients may be compensated for their part in the fraudulent scheme;
• Upcoding and unbundling: charging for services with exaggerated codes or unnecessary items that raise the price of a procedure.

Medicare
says that patients can help fight against fraud by guarding their Medicare information “like it’s a credit card”. If people get a hold of the information, they may be able to take advantage and defraud the government.

This article is not legal advice. It is presented
for informational purposes only.