MM Curator summary
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[MM Curator Summary]: “Marketers” and the parents/caregivers of Medicaid kids took kickbacks to help facilitate this dental services scheme.
Christian Agno Aquino, 42, of Humble, was arrested for his role in a $6.9 million Medicaid fraud and kickback scheme, alongside Rene Gaviola, 67, and Ifeanyi Ndubisi Ozoh, 51, of Houston, who were previously arrested. The defendants are charged with defrauding the Medicaid program through illicit practices committed through the Floss Family Dental Care clinic in Houston.
According to the indictment, Gaviola, the operator of Floss Family Dental Care, together with his managers Ozoh and Aquino, submitted fraudulent claims to Medicaid for pediatric dental services that were not provided or were in some cases performed by unlicensed individuals. The defendants are also accused of offering illegal kickbacks to marketers and caregivers of Medicaid-insured children, enticing them to bring the children to Floss for fraudulent dental services.
The indictment also details how Gaviola laundered Medicaid funds, transferring them from the Floss business bank account to his personal account in transactions exceeding $100,000. From 2019 to 2021, the dental clinic fraudulently billed Medicaid approximately $6.9 million.
The investigation was conducted by Sergeant Alfred Paige, Investigative Auditor Daryl Middleton, and Captain Alexander Chancia of the Texas Attorney General’s Medicaid Fraud Control Unit (“MFCU”), in cooperation with the FBI and the Department of Health and Human Services – Office of Inspector General. MFCU’s Assistant Attorney General Kathryn Olson, who also serves as a Special Assistant U.S. Attorney with the U.S. Attorney’s Office for the Southern District of Texas, is prosecuting the case along with Assistant U.S. Attorney Grace Murphy.
The OAG’s Medicaid Fraud Control Unit is dedicated to ensuring that those who exploit our healthcare system for personal gain are brought to justice by aggressively pursuing those who engage in healthcare fraud, working to safeguard taxpayer funds, and defending the integrity of vital healthcare programs. In the last fiscal year alone, the MFCU recovered more than $236 million in settlements and judgments for Texas taxpayers. In Texas, Medicaid costs taxpayers over $40 billion. Federal and industry authorities estimate that fraud comprises up to ten percent of the costs of the Medicaid program, making Medicaid fraud a $4 billion problem in Texas.
The MFCU receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $20,944,200 for fiscal year (FY) 2023. The remaining 25 percent, totaling $6,981,395, is funded by the State of Texas. For every dollar of state funding, the OAG’s MFCU recovers more than 33 dollars for taxpayers. If you suspect Medicaid fraud or abuse, or patient neglect, please report it by visiting the OAG’s website.