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Using The Family

Healthcare-Medicare-10
Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

According to Attorney General Brown, the case of Seyed Hamid Tofigh 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.” He wasn’t joking. Tofigh has been a licensed dentist in Maryland since September 1994 and owned several dental practices with two of his brothers. By 2015, all three brothers had separated their ownership of the different dental practices. Tofigh retained ownership of the practices in Greenbelt and Rockville, Maryland. However, Tofigh had no business owning a dentistry because he didn’t have a U.S. dental license. Official paperwork never stops a fraudster.

Some years are worse than others and 2015 was a bad one for Tofigh. Following several complaints from Tofigh’s patients, the Maryland Board of Dental Examiners suspended Tofigh’s license to practice dentistry, “due to a substantial likelihood that he posed a risk of harm to public health.” However, that didn’t stop Tofigh. As late as 2023, Tofigh continued to practice dentistry. It was found that during this time, he forged signatures on Medicaid applications, stole identities and created aliases. To avoid detection, Tofigh would sign notes “Dr. T.” because any of his brothers could have been “Dr. T.” Tofigh submitted claims for payment to Maryland Medicaid using the name, Medicaid provider number and credentials of his twin brother, his younger brother and his nephew. Those family members are all licensed dentists. In total, Tofigh received $8.5 million from Maryland Medicaid for services under these four providers.

Seyed Hamid Tofigh of Potomac pleaded guilty on February 7, 2024, to one count of defrauding a state health plan and one count of practicing dentistry without a license. He was sentenced to five years in prison on Friday, but the judge suspended all but 78 days, meaning he will only serve 78 days in prison. Is this equal to the fraud?

Today’s Fraud of The Day is based on article “Former Maryland children’s dentist steals $8.5 million from Medicaid” published by FOX5 DC on February 9, 2024

A former Maryland children’s dentist pled guilty to the theft of $8.5 million from the Medicaid program. The suspect has been identified as 57-year-old Seyed Hamid Tofigh. He ped guilty to one count of Defrauding a State health plan, the Medicaid program, and one count of Practicing Dentistry Without a License.

According to officials, Tofigh practiced dentistry without a license on Maryland Medicaid recipients, almost exclusively children, and used the names, provider numbers, and professional credentials of licensed dentists to submit claims.

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