Connecticut Dental Practices Pay Over $700,000 to Settle Medicaid Fraud Allegations

Two Connecticut dental providers have reached a civil settlement agreement with federal and state authorities to resolve allegations they violated federal and state False Claims Acts through an illegal patient referral scheme targeting Medicaid recipients.

Dr. Ivan Makar and Dr. Oleg Losin, along with their now-dissolved dental practices—Dent Plus Family Dentistry in Stamford and L&M Family Dentistry in New Haven—have agreed to pay $714,446.27 to reimburse the Connecticut Medicaid program for conduct that allegedly occurred between January 2019 and September 2020.

The settlement stems from a broader investigation into healthcare providers submitting kickback-tainted claims to the Connecticut Medical Assistance Program (CTMAP) for services provided to Medicaid patients referred through third-party recruiting companies.

According to federal and state authorities, the dental practices allegedly paid recruiters for each Medicaid patient referred to their offices—a practice explicitly prohibited under Connecticut healthcare regulations. With each claim submitted to Medicaid, investigators say the practices implicitly certified they had met all conditions for payment, including compliance with anti-kickback provisions.

“Patient recruiting schemes undermine the integrity of public healthcare programs and potentially compromise patient care,” said a spokesperson for the U.S. Attorney’s Office for the District of Connecticut, which announced the settlement. The spokesperson declined to disclose the identity of the third-party recruiting company involved or how many patients were affected by the arrangement.

The Connecticut Dental Health Partnership provider manual, which functions as an addendum to the CTMAP provider agreement, specifically prohibits per-patient compensation for individuals referred to providers participating in the Connecticut Medicaid program. These regulations aim to prevent financial incentives from influencing patient referrals and to ensure that medical necessity, rather than profit potential, drives healthcare decisions.

Healthcare fraud involving Medicaid has become an increasing concern for authorities nationwide. The Department of Health and Human Services Office of Inspector General has prioritized investigating kickback schemes, which can lead to unnecessary services, higher program costs, and compromised patient care.

Medicaid fraud affects taxpayers and vulnerable populations who depend on these programs for essential healthcare services. In Connecticut, the Medicaid program provides coverage for approximately 850,000 low-income residents, with dental services representing a significant portion of program expenditures.

While agreeing to the substantial settlement, neither the dentists nor their practices admitted liability as part of the civil settlement agreement.

The case highlights the increased scrutiny healthcare providers face regarding their billing and referral practices. Federal and state authorities have intensified efforts to detect and prosecute fraud in public healthcare programs, employing sophisticated data analytics and cooperating across jurisdictions to identify suspicious billing patterns.

Healthcare fraud costs American taxpayers billions of dollars annually, with dental fraud schemes representing a growing segment of investigations. Common dental fraud schemes include billing for services not rendered, misrepresenting procedures to obtain higher reimbursements, and, as alleged in this case, offering or accepting kickbacks for patient referrals.

Federal authorities encourage individuals who suspect healthcare fraud to report it through the HHS-TIPS hotline at 1-800-HHS-TIPS. Whistleblowers with information about healthcare fraud can sometimes receive a portion of funds recovered under the False Claims Act’s qui tam provisions, which allow private individuals to file lawsuits on behalf of the government.

The settlement represents a significant recovery for Connecticut’s Medicaid program and serves as a warning to healthcare providers about the consequences of participating in improper referral arrangements.