A dentist in Beverly Hills, CA, has been sentenced to one year in jail for insurance fraud.
Tom Kalili, DMD, who owned and operated Beverly Hills Medical Suites, submitted fraudulent billing to four insurers for $339,799.99, according to the California Department of Insurance. An investigation revealed that Dr. Kalili submitted billing for services not rendered, and, in most cases, the billing involved emergency dental procedures that were never performed. He also submitted false medical reports in support of fraudulent billing, which generally included fictitious mechanisms of injury.
Dr. Kalili pleaded no contest in April to one felony count each of insurance fraud and failure to file income tax returns, according to a patch.com story.
The investigation also revealed that Dr. Kalili submitted two fraudulent insurance claims on behalf of himself and his son to two automobile insurers. These claims included medical reports alleging he received treatment in auto accidents in 2005, 2008, and 2009 and for his son for treatment received for injuries sustained in a 2009 auto accident. Investigators found that these medical reports were fraudulently prepared. The dentist listed as providing treatment for the injuries claimed by Dr. Kalili denied performing the services.
Dr. Kalili was also sentenced to five years probation and paid $786,021 in restitution.
His former office manager, Claudia Ventura, pleaded no contest to two felony counts of insurance fraud. She is expected to be sentenced to 180 days in jail, 200 hours of community service, and five years probation.
