A dentist and his assistant plead guilty to a Medicaid fraud scheme

After reaching an agreement with the Public Ministry, a dentist and his administrative assistant pleaded guilty this Tuesday for a scheme of fraud to the Medicaidwhich consisted of claiming payment for services that were not rendered.

The Justice Department reported in a press release that Both were sentenced by Judge Ana Paulina Cruz Vélez, of the Court of First Instance of San Juan, to three years of probation..

Dennis Caban del Pilara dentist by profession, and Nayca Vargas Mondesiwho assisted him, certified services provided to elderly people in long-term care homes, minors, patients and deceased people, knowing that these were not provided or were provided by unauthorized dental assistants, revealed a investigation by the Puerto Rico Medicaid Fraud Control Unit (MFCU), attached to Justice.

With these claims, the agency explained, the now convicted violated provisions of the Penal Code and the Law on Fraudulent Claims to Programs, Contracts and Services of the Government of Puerto Rico.

“Both were sentenced to three years, to be served on probation, and had to repay the amount of $58,998.96, including fines and penalties. Similarly, Dr. Cabán is exposed to an exclusion from participation in Federal Programs for a minimum term of 5 years “indicated the director of MCFU, Luis Freire Borges.

The investigation was carried out by prosecutor Janice Maymí Camacho and agent Héctor I. López Sánchez of the Department of Justice’s Medicaid Fraud Control Unit. In addition, agents from the Office of the Inspector General of the United States Department of Health collaborated with the investigation, which began after a referral made by Delta Dental of Puerto Rico/Molina Health Care.

Justice explained that the Puerto Rico Medicaid Fraud Control Unit receives 75% of its funding from the United States Department of Health and Human Services under a grant totaling $1,246,103 for fiscal year 2021-2022; the remaining 25% is financed by the Government of Puerto Rico.

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