Imperial County Dentist and Former Office Manager Plead Guilty in Multi-Million Dollar Medicare Fraud

SAN DIEGO – Dr. Javad Aghaloo, an Imperial County dentist, and Theresa Flores, his office manager, pleaded guilty in federal court yesterday, admitting that they conspired to defraud Medicare and cover it up. 

Aghaloo entered a guilty plea to conspiring to commit health care fraud by billing Medicare for procedures that were not covered, not performed, or otherwise not necessary. As part of his plea, Aghaloo agreed to forfeit more than $1 million in property and pay restitution to Medicare in the amount of $8,476,466.23.  Flores entered a guilty plea to obstructing a Medicare audit.

According to court records, Aghaloo and others recruited Medicare beneficiaries to get dental work done at one of Aghaloo’s offices. To recruit Medicare patients, Aghaloo and Flores marketed dental services to individuals in Imperial County as being covered by Medicare. Aghaloo and Flores knew this was untrue since Medicare does not cover dental services.

Once a Medicare beneficiary was in one of Aghaloo’s offices, Aghaloo and others performed some type of procedure (usually a tooth extraction) and submitted false claims to Medicare using the person’s Medicare beneficiary number. Since tooth extractions are not covered by Medicare, Aghaloo’s offices instead submitted false claims for procedures like bone grafts that were never performed. 

Between March 1, 2016, and October 18, 2018, Aghaloo and Flores caused Aghaloo’s dental offices to submit over 7,000 false claims to Medicare, totaling over $18 million for which Aghaloo’s offices were paid $8,476,466.23 by Medicare. 

To conceal the fraud, between April of 2017 and October of 2018, Flores and Rosas caused false documents to be submitted to Noridian Healthcare Solutions, LLC. (“NHS”), a Federal auditor for the Medicare program.

Sentencing is set for January 12, 2024, at 9:00 a.m. before U.S. District Judge Jinsook Ohta.

This case is being prosecuted by Assistant U.S. Attorney Christopher Alexander. 

DEFENDANT                                               Case Number 23cr0616-JO                                     

Javad Aghaloo                                                Age: 50                                   San Diego, CA

Theresa Flores                                                 Age: 45                                   San Diego, CA

SUMMARY OF CHARGES

Conspiracy to Commit Health Care Fraud, a felony, in violation of Title 18, United States Code, Section 371.

Maximum Penalty:  Five years in prison and a fine of $250,000. 

Obstructing a Federal Audit, a felony, in violation of Title 18, United States Code, Section 1516.

Maximum Penalty:  Five years in prison and a fine of $250,000. 

AGENCIES

Federal Bureau of Investigation.

U.S. Department of Health and Human Services, Office of Inspector General.