Imperial County dentist sentenced to over three years in prison for Medicare fraud

SAN DIEGO, Calif. (KYMA, KECY) - The U.S. Attorney's Office said Javad Aghaloo, an Imperial County dentist, was sentenced in federal court on Friday to 37 months in prison for defrauding Medicare and then covering it up.

Melissa Rosas, who was Aghaloo's former billing manager, was sentenced to three years of probation with one year of home confinement.

She was sentenced for obstructing Medicare’s efforts to audit Aghaloo’s dental offices by providing false information. 

Both Aghaloo and Rosas and others conspired to commit healthcare fraud by billing Medicare for procedures that were not covered, performed, or necessary.

Aghaloo pleaded guilty to conspiracy to commit healthcare fraud on October 2, 2023.

While Rosas pleaded guilty to obstructing a federal audit on October 13, 2023.

The U.S. Attorney's Office said Aghaloo will have to forfeit more than $1 million in property bought with money obtained from the fraud and pay restitution to Medicare of $8,476,466.23.

Aghaloo and others recruited Medicare beneficiaries to get dental work done at one of his two dental offices in Imperial County, according to court records.

In order to recruit Medicare patients, Aghaloo and his team marketed their dental services as being covered by Medicare, and they were aware this was untrue since Medicare does not cover dental services.

The U.S. Attorney's Office said when a Medicare beneficiary was in one of Aghaloo's offices, he and others would perform some type of procedure.

They would also submit false claims to Medicare for the dental work by using the beneficiary's Medicare number.

While tooth extractions are not covered by Medicare, Aghaloo's offices submitted false claims for procedures such as bone grafts that were never performed.

The U.S. Attorney's Office said between March 1, 2016, and October 18, 2018, his dental offices submitted more than 7,000 false claims.

These false claims totaled over $18 million to Medicare to which Aghaloo’s offices received $8,476,466.23. 

The U.S. Attorney's Office said to conceal the fraud, between April 2017 and October 2018, Rosas and Aghaloo's office manager, Theresa Flores, submitted false documents to a Federal auditor for the Medicare program.

Flores pleaded guilty to obstructing an audit and will be sentenced on Friday, March 8.