Southern California dentist sentenced for $800K Medi-Cal fraud

By Legal Newsline

California Attorney General Rob Bonta announced the sentencing of a Southern California dentist and two employees for a fraudulent billing scheme that defrauded the state Medi-Cal program of nearly $800,000. Dr. Magaly Mercedes Velasquez and her spouse, Maria Jose Talavera, who served as an office manager, were sentenced by the Riverside County Superior Court to 364 days in jail and ordered to pay restitution amounting to $770,238 to Medi-Cal. Jessica Monique Perez, the billing manager, will be placed on probation for two years. The prosecution was conducted by the California Department of Justice’s Division of Medi-Cal Fraud and Elder Abuse (DMFEA).

“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,” said Attorney General Bonta. “Today’s sentencing holds Velasquez and others involved in this fraudulent billing scheme accountable and sends a strong message: The California Department of Justice is committed to safeguarding California’s communities and public programs and will not tolerate crimes against them.”

Velasquez owned U-First Dental practice where she served as a dentist from January 1, 2017, to December 31, 2019. Contracted with Borrego Community Health Foundation, a Federally Qualified Health Center participating in Medi-Cal, Velasquez received reimbursement for each day of service billed rather than for individual services provided. U-First Dental fraudulently split their services over multiple days on claims for reimbursement to maximize returns from Medi-Cal.

DMFEA protects Californians by investigating and prosecuting those who defraud the Medi-Cal program as well as those committing elder abuse. These settlements are facilitated through coordination among governmental agencies and assistance from whistleblowers reporting incidences at oag.ca.gov/dmfea/reporting.

DMFEA receives 75% of its funding from HHS-OIG under a grant award totaling $87,038,485 for federal fiscal year 2024. The remaining 25% is funded by the State of California. The federal fiscal year runs from October 1, 2023 through September 30, 2024.

A copy of the sentencing minute order will be available in the coming days.

Full Article & Source:
Southern California dentist sentenced for $800K Medi-Cal fraud