After a Six-Day Trial, Federal Jury Convicts Holy Health Care Services, LLC Program Administrator for a Health Care Fraud Scheme
Greenbelt, Maryland – A federal grand jury in Maryland has indicted licensed dentist Edward T. Buford III, age 68, of Silver Spring, Maryland; his business partner Kasandra Vilchez-Duarte, age 44, of Fort Washington, Maryland; and Donnie Amis, age 63, of Washington, D.C. on the federal charges of conspiracy to violate the federal Anti-Kickback Statute and conspiracy to commit health care fraud and mail fraud. The indictment was returned on July 13, 2020, and unsealed today at the defendants’ initial appearance.
The indictment was announced by United States Attorney for the District of Maryland Robert K. Hur; Special Agent in Charge James A. Dawson of the Federal Bureau of Investigation (FBI), Washington Field Office; Special Agent in Charge Maureen Dixon, Office of Investigations, Office of Inspector General of the Department of Health and Human Services (HHS OIG); Special Agent in Charge Michael McGill of the Social Security Administration - Office of Inspector General (SSA-OIG), Philadelphia Field Division; and Inspector General Daniel W. Lucas, District of Columbia, Office of the Inspector General (OIG).
According to the indictment, Buford was a licensed dentist in Washington, D.C., where he was the owner and chief executive officer of International Dental Associates, Inc. (IDA). Vilchez-Duarte was Buford’s business partner and manager of IDA. IDA was a provider with Medicaid from about July 2011 to the present and billed Medicaid for dental services purportedly provided to Medicaid beneficiaries. Buford was also enrolled as an individual Medicaid provider prior to April 10, 2015, when Medicaid suspended payments to Buford under his individual provider number. After that date, Buford and Vilchez-Duarte continued to submit claims to Medicaid through IDA’s Medicaid provider number. The indictment alleges that from January 2013 through May 2018, Buford and Vilchez-Duarte paid kickbacks to Amis to recruit Medicaid beneficiaries for which IDA billed, and received payment from, Medicaid.
Specifically, the indictment alleges that Buford and Vilchez-Duarte offered and paid kickbacks to Amis and others in exchange for referring Medicaid beneficiaries to IDA for dental services and even employed an individual to drive a van to transport recruited beneficiaries to IDA. Buford allegedly also sent text messages encouraging Amis and others to recruit Medicaid beneficiaries to refer to IDA for dental services, including dentures and extractions. Buford and Vilchez-Duarte paid Amis larger cash kickbacks, typically approximately $50 per beneficiary, for beneficiaries Amis recruited who agreed to be fitted for dentures than for beneficiaries who agreed to receive dental cleanings at IDA. Amis recruited Medicaid beneficiaries by offering cash bribes to induce them to visit and accept dental services, including dentures, from IDA. According to the indictment, Buford, Vilchez-Duarte, and Amis typically paid and caused to be paid approximately $20 to each recruited beneficiary who agreed to be fitted for dentures and approximately $10 to each recruited beneficiary who agreed to receive a cleaning from IDA. The beneficiaries typically only received the payment for the initial visit to be fitted for dentures, even though denture fittings require multiple visits and many beneficiaries never returned to IDA after receiving the cash payment. As a result, many beneficiaries never returned after the initial visit. On IDA’s premises, Buford, Vilchez-Duarte, and their co-conspirators stored hundreds of undelivered dentures, many of which had been billed to and paid for by Medicaid.
As detailed in the indictment, Buford, Vilchez-Duarte, and Amis submitted and caused to be submitted through IDA claims to Medicaid for dental services purportedly provided to the recruited beneficiaries. Medicaid then sent checks to a post office box in Silver Spring, Maryland, which Buford identified as IDA’s billing address, as payment for the dental services purportedly provided to the recruited beneficiaries. Further, the indictment alleges that in approximately April 2016, Buford and Vilchez-Duarte re-enrolled IDA in Medicaid. In the application, in response to the question, “Have you ever been suspended from the Medicare or Medicaid program, or has your participation status ever been modified (terminated, suspended, restricted, revoked, limited, cancelled),” Buford and Vilchez-Duarte failed to disclose Buford’s suspension from Medicaid.
According to the indictment, from January 2013 to February 2015, Buford and Vilchez-Duarte caused to be submitted to Medicaid under Buford’s individual provider number claims totaling $5.2 million and Medicaid paid approximately $2.7 million of those claims, including approximately $2 million in claims for dentures. From February 2014 to May 2018, Buford, Vilchez-Duarte, and Amis caused to be submitted to Medicaid through IDA claims totaling $12 million and Medicaid paid approximately $6.4 million of those claims, including approximately $4.5 million in claims for dentures.
If convicted, the defendants each face a maximum sentence of five years in federal prison for conspiracy to violate the federal Anti-Kickback Statute and a maximum of 20 years in federal prison for conspiracy to commit health care fraud and mail fraud. Actual sentences for federal crimes are typically less than the maximum penalties. A federal district court judge will determine any sentence after taking into account the U.S. Sentencing Guidelines and other statutory factors. The defendants had an initial appearance before U.S. Magistrate Judge Timothy J. Sullivan in U.S. District Court in Greenbelt today. The defendants were released pending trial.
An indictment is not a finding of guilt. An individual charged by indictment is presumed innocent unless and until proven guilty at some later criminal proceedings.
United States Attorney Robert K. Hur commended the FBI, HHS OIG, SSA OIG, and the District of Columbia OIG’s Medicaid Fraud Control Unit for their work in the investigation. Mr. Hur thanked Assistant U.S. Attorneys Gregory Bernstein and Jessica Collins, who are prosecuting the case.
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