Patients Were Almost Exclusively Children
Maryland Attorney General Anthony G. Brown announced the sentencing of former dentist Seyed Hamid Tofigh, 57, of Potomac, Maryland, relating to the theft of $8.5 million from the Medicaid program.
On February 6, 2024, Tofigh pleaded guilty to one count of Defrauding a State Health Plan, the Medicaid program, and one count of Practicing Dentistry Without a License, before the Honorable Carol Ann Corderre of the Circuit Court for Prince George’s County.
Tofigh accomplished this fraud scheme by practicing dentistry without a license on Maryland Medicaid recipients, almost exclusively children, and using the names, provider numbers, and professional credentials of licensed dentists to submit claims.
The Maryland Medicaid program is a joint federal-state program that provides healthcare benefits to low-income individuals. In total, Tofigh received $8.5 million from Maryland Medicaid for services that were fraudulently billed under the names of four other providers.
“This case revealed a complex healthcare fraud scheme that not only drained taxpayer dollars away from our State’s Medicaid program, but also placed Dr. Tofigh’s young patients in real danger,” said Attorney General Brown. “By stopping Dr. Tofigh, my office continues in its commitment to protecting patients and ensuring the integrity of State programs remains intact.”
Judge Corderre sentenced Tofigh to five years in jail, suspending all but seventy-eight days, and placed Tofigh on eighteen months’ home detention, with a five-year term of probation for the Medicaid fraud count, and to one year in jail, suspended, followed by a five-year term of probation for practicing dentistry without a license. Both sentences are to run consecutively.
Judge Corderre also ordered Tofigh to pay $8.5 million in restitution within one year.
At the time of sentencing, Tofigh had made one $4.5 million payment toward restitution. Lastly, Tofigh is prohibited from providing healthcare services that are either partially or wholly funded by state or federal governments and must permanently surrender his Maryland dental license.
Tofigh had been a licensed dentist in Maryland since September 1994 and owned several dental practices with two of his brothers. By 2015, all three brothers separated their ownership of the different dental practices, while Tofigh retained ownership of Greenbelt Family Dentistry, located at 7500 Hanover Parkway, Greenbelt, Maryland, and Rockville Family Dentistry, located at 5806 Hubard Drive, Rockville, Maryland.
In March 2014, following several complaints from Tofigh’s patients, the Maryland Board of Dental Examiners suspended Tofigh’s license to practice dentistry, finding that there was a substantial likelihood that he posed a risk of harm to public health, safety, and welfare.
The Board conducted further investigation and in February 2015 revoked Tofigh’s license to practice dentistry, finding that he kept “consistently incompetent and egregiously deficient” dental records, provided incompetent and substandard treatment to patients, fraudulently billed for services never provided, and engaged in unprofessional and dishonorable conduct.
Only a licensed dentist may own a dental practice and perform dentistry. From 2015 through January 2023, Tofigh continued to own the Greenbelt and Rockville practices and continued to practice dentistry on Maryland Medicaid recipients. Tofigh stole the identities of others, forged signatures on Medicaid applications, used aliases to avoid detection, directed his employees to use aliases to avoid accountability, and failed to cooperate with insurance audits.
Tofigh, when he wrote notes, would sign them “Dr. T.” In that manner, any of the Tofighs could have been “Dr. T.”
He also continued to bill for services he did not provide; continued to deliver substandard care to patients; used equipment that was not properly sanitized; performed and billed for unnecessary services, such as unnecessary root canals, fillings, and tooth extractions; bullied and intimidated patients who questioned him; and kept very little documentation of services he claimed to have provided.
In sum, Tofigh’s practice of dentistry continued to fall below professional standards, resulting in pain, suffering, and infections to children with Maryland Medicaid health insurance.
From 2015 through 2022, Tofigh submitted claims for payment to Maryland Medicaid utilizing the name, Medicaid provider number, and credentials of his twin brother, his younger brother, and his nephew, all of whom are licensed dentists.
Tofigh also used the credentials and Medicaid provider number of a former colleague to submit fraudulent claims to the Medicaid program.
Tofigh was paid $416,850 for fraudulent claims filed under his twin’s credentials, $3,143,975 for fraudulent claims filed under his younger brother’s credentials, $4,751,127 for fraudulent claims filed under his nephew’s credentials, and $218,950 for fraudulent services filed in two months under a former colleague’s credentials.
In making today’s announcement, Attorney General Brown thanked Assistant Attorneys General Catherine Schuster Pascale and James M.C. McHale, and Senior Investigative Auditor Todd Sheffer, Senior Fraud Analyst Shannon Beatty, Fraud Analyst Gordon Carew, and Senior Fraud Analyst Paul Kidd of the Attorney General’s Medicaid Fraud and Vulnerable Victim’s Unit for their work on this case.
Attorney General Brown also thanked the Office of Inspector General, Health and Human Services Special Agent in Charge Maureen Dixon, Assistant Special Agent in Charge Andre Jacobs, and Special Agent Jamila Shelton and the Department of Homeland Security, Homeland Security Investigations Baltimore.
The Maryland Office of the Attorney General, Medicaid Fraud and Vulnerable Victims Unit receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $6,057,128 for Federal fiscal year (FY) 2024.
The remaining 25 percent, totaling $2,019,042 for FY 2024, is funded by the State of Maryland.
