Pediatric Dentist Pays $1.3 Million to Settle False Claims Act Allegations

Deirdre M. Daly, United States Attorney for the District of Connecticut, Connecticut Attorney General George Jepsen, and Phillip M. Coyne, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General, today announced that JESUS VILLEGAS, DDS, and his two pediatric dental clinics located in Milford and West Haven have entered into a civil settlement agreement with the federal and state governments in which they will pay $1,367,466 to resolve allegations that they violated the federal and state False Claims Acts.

The allegations arise out of the taking of pediatric dental x-rays at FAIRFIELD PEDIATRIC DENTISTRY, LLC (“FAIRFIELD”) in Milford and HAVEN PEDIATRIC DENTISTRY, LLC (“HAVEN”) in West Haven.  Under Connecticut law, a licensed dentist may delegate to dental assistants the taking of dental x-rays if the dental assistant can demonstrate successful completion of the dental radiography portion of an examination prescribed by the Dental Assisting National Board (“DANB”).  The certification provided by the DANB examination is important to ensure dental assistants are appropriately trained in the use of x-ray procedures and to ensure the x-rays are performed safely.

The federal and state governments allege that the majority of x-rays taken at DR. VILLEGAS’ dental clinics were taken by dental assistants who were not DANB certified.  X-rays taken by uncertified dental assistants are not payable by the Medicaid program.

To resolve the allegations under the federal and state False Claims Acts, VILLEGAS, FAIRFIELD and HAVEN have agreed to pay $1,367,466, which covers conduct occurring from June 1, 2010 through and including March 17, 2014.

As part of the settlement, VILLEGAS, FAIRFIELD and HAVEN have entered into a three-year billing Integrity Agreement with the U.S. Department of Health and Human Services that is designed to ensure future compliance with the requirements of federal healthcare programs.

“Health care providers must utilize properly certified individuals to treat patients, and the failure to ensure such proper care for patients will have serious consequences,” said U.S. Attorney Daly.  “The U.S. Attorney’s office is committed to vigorously pursuing health care providers who submit false or fraudulent claims to federal health care programs.”

“Dentists must ensure that only certified staff provide services to their patients,” said HHS-OIG Special Agent in Charge Coyne.  “Cutting corners could jeopardize the safety of patients and the integrity of the Medicaid program.  Working with our law enforcement partners, our agency is dedicated to protecting patients and the government health care programs designed to serve them.”

This matter was investigated by the Office of Inspector General for the Department of Health and Human Services and is being prosecuted by Assistant U.S. Attorney Richard M. Molot and Auditor Kevin Saunders, and by Assistants Attorney General Karen S. Haabestad and Natasha Freismuth of the Connecticut Office of the Attorney General.

People who suspect health care fraud are encouraged to report it by calling 1-800-HHS-TIPS or the Health Care Fraud Task Force at (203) 777-6311.