HARTFORD, Conn — Two individuals and three Family Dentistry, or FD, businesses in Connecticut have entered into a civil settlement agreement, paying $1.7 million to resolve alleged violations of the federal and state False Claims Act.
According to the U.S. Attorney for the District of Connecticut and Attorney Gen. William Tong, Stanislaw Gintautas, DDS; Tatiana Agababaeva, DDS; and their businesses - FD Bridgeport; FD Hartford PLLC; and FD Stamford PC - entered into the agreement with the federal and state governments on Wednesday.
Gintautas and Agababaeva are both licensed to practice dentistry in Connecticut. Prosecutors say Gintautas and Agababaeva and the three dentistry businesses are enrolled as dental providers in the Connecticut Medical Assistance Program, or CTMAP, which includes the state’s Medicaid program.
Prosecutors allege that the CTMAP provider agreements and the federal Anti-Kickback Statute were violated when FD Bridgeport, FD Hartford, FD Stamford and Gintautas submitted claims to the CTMAP related to dental services given to Connecticut Medicaid patients referred to the businesses by a third-party “patient recruiting” company.
FD Bridgeport, FD Hartford, FD Stamford and Gintautas paid a patient recruiter. It is alleged the recruiter received $115 for each Connecticut Medicaid patient that they referred to the dentist offices whenever the patient received services going beyond the scope of routine preventative care, including dental cleanings and exams. The offices submitted claims for dental services rendered to each patient.
However, prosecutors allege that with each submitted claim, the offices “impliedly certified” that the conditions of receiving payment were not met, including, but not limited to, that they did not pay kickbacks or violate any terms or provisions of the Connecticut Dental Health Partnership, or CTDHP, provider manual concerning the submitted claim.
Prosecutors note that the CTDHP provider manual, which they refer to as an addendum to both the CTMAP provider agreement and the CTMAP provider manual, prohibits per-patient compensation for individuals referred to CMAP providers.
FD Bridgeport, FD Hartford, FD Stamford, Gintautas and Agababaeva paid $1.7 million to reimburse the Medicaid program for conduct that occurred from February 2016 through August 2018.
Prosecutors say the payment resolves allegations under the federal and state False Claims Act.
Under the False Claims Act, the government can recover up to three times its actual damages as well as penalties of $13,946 to $27,894 for each false claim.
Prosecutors say that the case is connected to a larger investigation into fraudulent activity by health care providers who submit kickback-tainted claims to the CTMAP for services delivered to Connecticut Medicaid patients referred by third-part patient recruiting companies.
The investigation was led by the FBI, the U.S. Department of Health and Human Services, Office of Inspector General and the Connecticut Attorney General’s Office and the Connecticut Department of Social Services.
Those who suspect health care fraud can report it by calling 1-800-HHS-TIPS.
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Dalton Zbierski is a digital content producer and writer at FOX61 News. He can be reached at dzbierski@FOX61.com.
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