Tofigh cunningly executed this fraudulent scheme by illegally practicing dentistry on Maryland Medicaid recipients, primarily children, without a valid license. He deceitfully utilized the identities, provider numbers, and professional qualifications of licensed dentists to file claims and deceive the system.
Maryland Attorney General Anthony G. Brown has announced the sentencing of former dentist Seyed Hamid Tofigh, aged 57, from Potomac, Maryland, in connection with the theft of $8.5 million from the Medicaid program.
Tofigh pleaded guilty on February 6, 2024, to one count of Defrauding a State Health Plan, specifically the Medicaid program, and one count of Practicing Dentistry Without a License, before Judge Carol Ann Corderre of the Circuit Court for Prince George’s County.
Tofigh carried out this fraudulent scheme by providing dental services without a license to Maryland Medicaid recipients, primarily children, and using the names, provider numbers, and professional credentials of licensed dentists to submit claims. Maryland Medicaid is a joint federal-state program that offers healthcare benefits to low-income individuals. In total, Tofigh received $8.5 million from Maryland Medicaid for services that were falsely billed under the names of four other providers.
Attorney General Brown said, "This case revealed a complex healthcare fraud scheme that not only drained taxpayer dollars away from our State’s Medicaid program, but also placed Dr. Tofigh’s young patients in real danger.” “By stopping Dr. Tofigh, my office continues in its commitment to protecting patients and ensuring the integrity of State programs remains intact.”
Judge Corderre sentenced Tofigh to five years in jail, with all but seventy-eight days suspended, and placed him on eighteen months' home detention, followed by a five-year term of probation for the Medicaid fraud charge.
Additionally, Tofigh received a one-year jail sentence, suspended, followed by a five-year probation term for practicing dentistry without a license. Both sentences are to be served consecutively. Judge Corderre also mandated that Tofigh pay $8.5 million in restitution within one year. At the time of sentencing, Tofigh had already made a $4.5 million payment toward restitution.
Furthermore, Tofigh is prohibited from providing healthcare services funded by state or federal governments, and he must permanently surrender his Maryland dental license. Tofigh had been a licensed dentist in Maryland since September 1994 and had owned several dental practices with his two brothers. By 2015, the brothers had separated their ownership of different dental practices, with Tofigh retaining ownership of Greenbelt Family Dentistry in Greenbelt, Maryland, and Rockville Family Dentistry in Rockville, Maryland.
In March 2014, after receiving numerous patient complaints, the Maryland Board of Dental Examiners suspended Tofigh's dental license due to concerns about potential harm to public health and safety. Following further investigation, the Board revoked Tofigh's license in February 2015, citing consistently incompetent and severely deficient dental record-keeping, substandard patient treatment, fraudulent billing for services not rendered, and unprofessional conduct.
Ownership and practice of dentistry are restricted to licensed dentists. Despite losing his license, Tofigh maintained ownership of the Greenbelt and Rockville dental practices from 2015 to January 2023, and continued to treat Maryland Medicaid patients. To avoid detection, he stole identities, forged signatures on Medicaid documents, and used aliases for himself and his employees.
Tofigh also failed to cooperate with insurance audits and signed his notes as "Dr. T.," making it unclear which "Dr. T." was responsible. He persistently overbilled for services, provided subpar care, used unsanitary equipment, performed unnecessary procedures like root canals and extractions, intimidated patients, and kept minimal documentation. These practices led to pain, suffering, and infections among children covered by Maryland Medicaid.
From 2015 to 2022, Tofigh submitted fraudulent claims to Maryland Medicaid using the identities, Medicaid provider numbers, and professional credentials of his twin brother, younger brother, and nephew, all licensed dentists. He also utilized a former colleague's credentials for false claims. Tofigh received $416,850 for claims under his twin's credentials, $3,143,975 under his younger brother's, $4,751,127 under his nephew's, and $218,950 under the former colleague's credentials for services not rendered.
He also acknowledged the Office of Inspector General, Health and Human Services Special Agent in Charge Maureen Dixon, Assistant Special Agent in Charge Andre Jacobs, Special Agent Jamila Shelton, and the Department of Homeland Security, Homeland Security Investigations – Baltimore, for their assistance.
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