Attorney General Lockyer Files Lawsuit Alleging Medi-Cal Dental Program Fraud
Southern California Clinics Provided Unlicensed, Unnecessary Work on Children
(SACRAMENTO) – Attorney General Bill Lockyer today announced his office has filed a major Medi-Cal fraud lawsuit against eight individuals involved in four dental clinics in Los Angeles and Riverside counties. The defendants are charged with stealing the identity of unsuspecting dentists to bilk the Medi-Cal system of at least $380,000.
"None of these individuals were licensed to practice, yet they performed dental work on dozens of children and adults and stole the identities of real dentists to illegally bill Medi-Cal," Lockyer said. "These scammers not only put the health of innocent people at risk, they also ripped off California taxpayers. Through aggressive enforcement actions like these, we can protect the public's health and tax dollars."
The eight defendants are charged with a total of 64 counts of conspiracy to commit grand theft, conspiracy to commit Medi-Cal fraud, money laundering, identity theft and paying "kickbacks" for bringing in Medi-Cal beneficiaries for dental services.
In a 57-page complaint filed Thursday in Los Angeles Superior Court, the Attorney General's Office alleges the scam was masterminded by Enrique Valer, Julio Javier Romo and Zubin Plasencia, none of whom were licensed to practice dentistry. Between the three, they operated four different dental clinics: Daval Dental Clinic in Huntington Park, Don Bosco Dental Clinic in Moreno Valley and Santa Rosa Dental Office in Norwalk, which later was operated under the name of Millennium Dental.
The complaint alleges the two hired unsuspecting dentists and then used, without their knowledge, the dentists' Medi-Cal provider numbers to submit false claims for services that were not performed or were rendered by unlicensed staff. In other instances, they stole the identities of the dentists they hired and used that information to open bank accounts and credit accounts with dental supply companies.
The defendants also were charged with paying illegal "kickbacks" to individuals who brought Medi-Cal beneficiaries to the clinics for dental services, some of which were unnecessary. In many cases, the dental exams, cleanings, and procedures were performed by unlicensed and untrained employees at the clinics.
Named as defendants are:
Valer, 47, of Downey
Romo, 45, of Arcadia
Plasencia, 35, of West Covina
Gabriel Humberto Rios, 51, of Arcadia
Monica Maximiliano, 32, of West Covina
Juan Carlos Avila, 32, of Bell
Teresa Mendivil, 48, of Long Beach
Carmen Revelli, 46 of Lakewood
The case is one of more than two dozen investigations being conducted by the Attorney General's Bureau of Medi-Cal Fraud and Elder Abuse (BMFEA) into individuals suspected of defrauding the Medi-Cal Dental Program, which provides dental services for low-income Californians. The case was jointly investigated with the Los Angeles County Health Authority Law Enforcement (HALT) Task Force and the California Department of Health Services.
The complaint can be viewed at http://ag.ca.gov/newsalerts/cms03/03-031.pdf