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Case Number: 3:17-cv-01415-E
Judge: Ada Brown
Court: United States District Court for the Northern District of Texas ( County)
Plaintiff's Attorney: United States District Attorney’s Office
Description: Dallas, TX - Drs. Gunjan Dhir, 43, and Gaurav Puri, also 43, have owned and operated dental clinics and dental management companies throughout Texas since 2009. The clinics serve primarily low-income children enrolled in the Texas Medicaid program; the dental management companies provide management and administrative services to the clinics. After opening their first dental clinic in 2009, Drs. Dhir and Puri rapidly expanded their operation to include 35 dental clinics operating statewide by 2015.
Funded jointly by the states and the federal government, Medicaid is intended to serve low-income families and children. The State of Texas paid for part of the Medicaid claims at issue and will receive approximately half of the government’s share of the settlement amount.
The Government claimed that the defendants knowingly defrauded Medicaid, a program that provides medical coverage for more than 4 million low-income Texans. They thought they could get away with this scam by targeting underprivileged populations, they were sorely mistaken. Drs. Dhir, Puri, and their affiliated management companies and pediatric dental clinics submitted or caused the submission of false claims for payment to the Texas Medicaid Program for fillings in children that were not actually performed. They also submitted or caused the submission of claims using erroneous Medicaid provider numbers misrepresenting the dentists who performed pediatric procedures.
Part of the allegations resolved by this settlement were originally filed under the qui tam, or whistleblower, provisions of the False Claims Act by relators Sandy Puga, Nelda Torres-Brown, and Sonia Cardoso, all former employees of the implicated dental management companies and/or pediatric dental practices, who will receive a fraction of the settlement. (The Act permits private persons with evidence of fraud to sue on behalf of the government for false claims for government funds and to receive a share of any recovery.)
The case was handled for the government by Assistant U.S. Attorneys Kenneth Coffin and Braden Civins on behalf of the Department of Health & Human Services Office of Inspector General and the State of Texas, with assistance from the Texas Attorney General’s Office, Civil Medicaid Fraud Division.
The claims resolved by the settlement are allegations only and there has been no determination of liability.
Outcome: Defendants agreed to pay $3.1 million to settle the claims made against them.