Former Dentist Pleads Guilty to Health Care Fraud
WASHINGTON – Bilal Ahmed, 47, of Potomac, Maryland, pled guilty on September 6, 2019, to a federal charge of health care fraud stemming from a scheme in which he and others caused the District of Columbia’s Medicaid program to be defrauded out of more than $5 million.
The announcement was made today by U.S. Attorney Jessie K. Liu, Timothy Dunham, Special Agent in Charge, Criminal Division, FBI Washington Field Office, Maureen R. Dixon, Special Agent in Charge of the U.S. Department of Health and Human Services Office of Inspector General, for the region that includes Washington, D.C., and Daniel W. Lucas, District of Columbia Inspector General.
Ahmed was indicted in January 2019, along with his former office manager, on one count of conspiracy to commit health care fraud, one count of health care fraud, and five counts of wire fraud. Ahmed pled guilty in the U.S. District Court for the District of Columbia to Count II of the Indictment and the remaining charges will be dismissed at sentencing. The charge carries a statutory maximum sentence of 10 years in prison and potential financial penalties. Under federal sentencing guidelines, Ahmed faces a likely range of 57 to 71 months in prison and a fine of up to $200,000. The plea agreement calls for Ahmed to pay $5,421,227 in restitution and $3,978,879.93 in a forfeiture money judgment. While the government has agreed to join in Ahmed’s request for a sentence that runs concurrently with the 16-year sentence that he currently is serving for sexually assaulting patients, that request is not binding on the Court. The Honorable Judge Colleen Kollar-Kotelly scheduled sentencing for January 17, 2020.
According to the statement of offense submitted to the Court, Ahmed was a practicing dentist who owned and operated Universal Smiles, a dental practice, in Northwest, Washington, D.C. When Ahmed’s dental license was suspended by the D.C. Dentistry Board, and subsequently was surrendered by him, Ahmed opened and operated Dental Equipment and Services (“DES”). DES was a Maryland company that employed dentists on contract to work at Universal Smiles’ former business location in the District of Columbia. Through Universal Smiles and DES, Ahmed and his office manager, engaged in a scheme to enrich themselves by defrauding D.C. Medicaid, a health care benefits program jointly funded by the federal government and the District of Columbia to provide health care services to residents who meet the income qualifying requirements. As part of the scheme, Ahmed with the assistance of the office manager, applied to be a Medicaid provider. Once approved to bill Medicaid, Ahmed and the office manager sought to increase the dental practice’s profits by recruiting Medicaid recipients as patients. Ahmed and the office manager then billed D.C. Medicaid for thousands of provisional crowns that were not provided to the Medicaid patients and shared the fraud proceeds. From August 9, 2012, through February 26, 2014, D.C. Medicaid paid Universal Smiles approximately $12.4 million; and it paid DES approximately $1.2 million from November 17, 2014, though February 1, 2016. Of the more than $13 million that D.C. Medicaid paid to Universal Smiles and DES, approximately $5.4 million was for provisional crowns. Of the $5.4 million that D.C. Medicaid paid for provisional crowns, Ahmed obtained approximately $4 million from the fraudulent scheme and the office manager obtained approximately $1.4 million.
In announcing the plea, U.S. Attorney Liu, Special Agent in Charge Dunham, and Special Agent in Charge Dixon commended the work of those who investigated the case from the FBI’s Washington Field Office, the U.S. Department of Health and Human Services Office of Inspector General, and the District of Columbia’s Office of the Inspector General. They also expressed appreciation for the work of Paralegal Specialists Aisha Keys and Brittany Phillips, Forensic Financial Analyst Bryan Snitselaar, and the DC OIG MFCU investigations team. Finally, they commended the work of Assistant U.S. Attorney Denise A. Simmonds, and former Assistant U.S. Attorneys Michelle Bradford and Lionel Andre, who prosecuted the case.