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  • Writer's pictureJames A. Gustino

It's the Big House for Big Fraud!

//Chief U.S. District Judge Randy Crane has now ordered Gaviola to serve 120 months in federal prison to be immediately followed by three years of supervised release. In addition, Judge Crane ordered Gaviola to pay $4,908,957.89 in restitution to Medicaid and a personal money judgement of $2,996,092. ***

Gaviola was the operator of Floss Family Dental Care clinic in Houston. From 2018 until April 2021, Gaviola submitted fraudulent claims to Medicaid for pediatric dental services, including numerous cavity fillings which Floss did not provide or unlicensed individuals provided.

Gaviola illegally employed his son, who was not a licensed dentist, to provide dental services to Medicaid-insured children and occasionally operated Floss without any licensed dentists present. Floss then fraudulently billed Medicaid for these services.

Gaviola also paid kickbacks to marketers and caregivers of Medicaid-insured children to bring them to Floss for dental services.//

A victory for the good guys to be sure, but I'm afraid that this is merely the tip of a very large iceberg. Fraud continues to be rampant in the Medicare and Medicaid world despite harsh criminal and treble damage civil laws. The temptation is simply too great for these fraudsters -- and government resources spread too thin to be tuly effective...

That's why whistleblowers who bring False Claims Act cases are so critically important to preserving the solvency of Medicare and Medicaid programs for ourselves, children and grandchildren.

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