A dentist who reportedly used family members and colleagues’ identities to file $8.5 million in fake Medicaid claims while his license was revoked for providing substandard care to children was sentenced, according to the Maryland Office of the Attorney General.
Dr. Seyed Hamid Tofigh, 57, pleaded guilty on February 6 to defrauding a state health plan and practicing dentistry without a license. Tofigh was sentenced to five years in prison, suspending all but 78 days of his time. He was also placed on 18 months of house arrest plus probation, according to a press release dated February 9 from the state attorney general’s office.
Also, the Potomac, MD, resident was ordered to pay $8.5 million in restitution within one year. At his sentencing, Tofigh paid $4.5 million in restitution. Furthermore, Tofigh had to surrender his Maryland dental license permanently and is prohibited from providing healthcare services that are partially or totally funded by state or federal governments.
“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,” Maryland Attorney General Anthony Brown said in the release.
Since 1994, Tofigh had been a licensed dentist in Maryland, owning several dental practices with two of his brothers. In March 2014, the Maryland Board of Dental Examiners suspended Tofigh’s dental license, citing a substantial likelihood that he posed a risk of harm to public health, safety, and welfare following complaints from his patients, who were mostly children, according to the release.
By 2015, all three brothers separated their ownership of the practices with Tofigh, retaining ownership of Greenbelt Family Dentistry and Rockville Family Dentistry.
In February 2015, the dental board revoked Tofigh’s dental license after further investigation revealed he kept “consistently incompetent and egregiously deficient” dental records, provided substandard treatment to patients, fraudulently billed for services never rendered, and engaged in unprofessional and dishonorable conduct, according to the release.
Though only a licensed dentist may own a practice and perform dentistry, Tofigh purportedly continued to own his two practices and provide dental services to patients receiving Medicaid from 2015 through January 2023. Tofigh allegedly used the identities and Medicaid provider numbers and credentials of his twin brother, his younger brother, his nephew, and a former colleague to obtain reimbursements from the state dental program, according to the release.
The dentist allegedly 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. Also, according to the release, he reportedly billed for services he did not provide; continued to deliver substandard care to patients; used equipment that was not properly sanitized; performed and billed for unneeded services, including unnecessary root canals; bullied and intimidated patients who questioned him; and kept records of services he claimed to have provided.
Over time, Tofigh’s practice of dentistry continued to fall below professional standards, resulting in pain, suffering, and infections in his pediatric patients. During this time, Medicaid paid Tofigh $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 fake claims filed in only two months under a former colleague’s credentials.