Dentist, her wife, 3rd employee sentenced for $800K in fraud

A dentist, her wife who worked at the California practice, and a billing manager were sentenced on July 22 for their roles in reportedly defrauding the state Medicaid program out of about $800,000, according to the State of California Office of the Attorney General.

Dr. Magaly Mercedes Velasquez, a dentist and the owner of U-First Dental Care in Rancho Cucamonga, CA, and her spouse and practice office manager, Maria Jose Talavera, were sentenced to 364 days in jail and ordered to pay $770,238 in restitution to Medi-Cal, the state's Medicaid program. Jessica Monique Perez, the practice billing manager, was sentenced to two years of probation, according to a press release dated July 22 from the state attorney general.

"When dentists like Velasquez defraud Medi-Cal to line their own pockets, they jeopardize the program's ability to provide necessary healthcare services to our most vulnerable patients," Attorney General Rob Bonta said.

Between January 2017 and December 2019, Velasquez, Talavera, and Perez allegedly engaged in a fraudulent billing scheme to defraud Medi-Cal. While U-First was contracted with Borrego Community Health Foundation, a federally qualified health center that participates in Medi-Cal, Velasquez purportedly received reimbursement for each day of service billed rather than for individual services provided to patients. To reportedly maximize reimbursement from Medi-Cal, U-First Dental fraudulently split their services over multiple days on its claims for repayments, according to the release.