Not to be confused with the Medicare program run by the U.S. government, Medicaid is a joint federal-state program that provides funds for medical services to lower-income individuals who qualify for benefits.
The program is jointly administered by the U.S. Department of Health and Human Services and supervised by the Centers for Medicare and Medicaid Services. In Connecticut, the Medicaid program is administered by the Connecticut Department of Social Services.
In the fall of 2008, a man was hired by Gary Anusavice to work as a dentist at Landmark Dental, a dental practice in West Haven, Connecticut, that Anusavice had opened earlier in the year. At the time, Anusavice was a convicted felon, former dentist, and excluded Medicaid provider.
Although Anusavice remained the primary decision maker for the business, the man he hired became the dentist whose name and license were used as the front for the practice.
Medicaid provider application
In approximately January 2009, the front man signed an application for Landmark Dental to become a Medicaid provider. The application did not disclose that Anusavice had an ownership interest in Landmark Dental, that he was subject of prior disciplinary and criminal actions, and that he was excluded from the Medicaid program.
Even though the front man was aware of Anusavice’s disciplinary history, he also signed Medicaid provider applications for two other dental practices operated by Anusavice, Dental Group of Stamford and Dental Group of Connecticut in Trumbull.
Both applications also failed to disclose Anusavice’s background and involvement in the practices.
Following the fraudulent provider applications, from approximately January 2009 to March 2011, the front man submitted or caused to be submitted numerous claims to Connecticut Medicaid, for which reimbursement payments were made.
$21 million reimbursed
As a result of this fraud, the Connecticut Medicaid program reimbursed Anusavice’s dental practices nearly $21 million.
Mehran Zamani, DDS, 50, of Pound Ridge, New York, pleaded guilty to one count of obstructing the administration of a federal health care program. He is scheduled to be sentenced in July 2015. He faces a maximum term of imprisonment of three years.
In March 2015, Zamani signed a settlement agreement to resolve civil matters with the U.S. Attorney’s Office and the State of Connecticut. Under the terms of the agreement, Zamani agreed to pay $200,000, forfeit a dental office he owned in Hartford, and give up all rights to approximately $1.9 million in Medicaid dollars that had been suspended by the Connecticut Department of Social Services.
He also agreed to be excluded from all federal health care programs for a period of 10 years.
In 2013, Anusavice pleaded guilty to health care fraud and tax evasion offenses stemming from his involvement in this scheme. He was sentenced to 97 months in prison. In addition, he was ordered to pay restitution of more than $5.2 million, and back taxes of more than $1.8 million, plus interest and penalties
He also forfeited his Rhode Island residence, a 33-foot yacht, a Mercedes Benz automobile and approximately $91,700 in cash.
Anusavice also has agreed to pay the state $9.9 million, which represents treble damages under the Connecticut False Claims Act and restitution under the Connecticut Unfair Trade Practices Act.