Baum Hedlund Aristei & Goldman whistleblower attorneys announced the successful resolution of a qui tam case against two North Texas dentists accused of fraudulently billing the state's Medicaid program for pediatric dental services.
Dr. Gunjan Dhir, Dr. Gaurav Puri, and their affiliated dental businesses will pay the United States government $3.1 million to resolve whistleblower allegations that they violated the federal False Claims Act and defrauded the Texas Medicaid program. According to the claims, the dentists and companies under their control knowingly billed for pediatric dental services that were either not rendered or falsely identified the person who provided the service.
Baum Hedlund whistleblower attorneys Mark H. Schlein and Diane Marger Moore represented whistleblowers Sandy Puga, Nelda Torres-Brown, and Sonia Cardoso, all former employees of Dr. Dhir and/or Dr. Puri. These brave whistleblowers brought fraud allegations to the government's attention, which led to the successful enforcement action announced today.
Civilians with knowledge of fraud against the government may file whistleblower claims to recover ill-spent government funds. If the claim is successful, the whistleblowers (or relators) may receive a reward. In this case, the whistleblowers will share a portion of the settlement for bringing the pediatric dental fraud claims to the government's attention.
"Unfortunately, fraud committed by unscrupulous dental providers is widespread in America," said attorney Mark H. Schlein, who heads Baum Hedlund's whistleblower litigation team. "It is even more reprehensible when the victims are young children. I am proud to have represented the whistleblowers in this case who saw what was happening, knew it was wrong and had the courage to stand up and do what was necessary to stop it. All of us appreciate the hard work and determination of the federal prosecutors and investigators that made this outcome possible."
Texas Dentists Accused of Submitting False Claims for Pediatric Dental Services
Dr. Dhir and Dr. Puri have owned and operated dental clinics and dental management companies in Texas for over a decade. The two dentists opened their first clinic in 2009, focusing primarily on servicing low-income children enrolled in the Texas Medicaid program. After six years in business, their operation swelled to include 35 clinics.
According to the healthcare fraud allegations, between 2011 and 2017, Dr. Dhir and Dr. Puri, along with their affiliated companies and clinics, knowingly submitted or caused the submission of false claims to the Texas Medicaid Program. By submitting these false claims, the dentists and their affiliated businesses received remuneration for fillings in children that were not actually performed. The dentists were also accused of submitting or causing the submission of claims using false Medicaid provider numbers that misrepresented the dentists who performed pediatric procedures.
States and the federal government jointly fund Medicaid. Texas paid for part of the Medicaid claims at issue in this case. Per the terms of the settlement agreement, the State of Texas will receive approximately half of the government's share of the recovery.
Baum Hedlund Aristei & Goldman | Whistleblower Attorneys
Baum Hedlund Aristei & Goldman represents men and women who come forward and expose fraud against the government. We share in their purpose to protect the integrity of programs like Medicare and Medicaid. With decades of whistleblower experience, our attorneys understand the schemes that companies deploy to defraud the government and consumers. Across all areas of practice, the firm has won more than $4 billion in verdicts and settlements.