A former dental clinic operator in Houston has been sentenced for orchestrating a multi-million dollar Medicaid fraud and kickback scheme.
PREVIOUS: $6M pediatric dental fraud scheme revealed: Dental clinic operator, 2 managers charged
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According to the U.S. Attorney’s Office in the Southern District of Texas, Rene Gaviola, 68, has been ordered to serve 120 months in federal prison as well as pay more than $5 million in restitution to Medicaid and over $3 million in personal money judgment.
Court records claim Gaviola was the operator of Floss Family Dental Care clinic, where he submitted fake claims to Medicaid for pediatric dental services. These included several cavity fillings, which Floss did not provide and if they did, were done so by unlicensed individuals. One of those individuals included Gaviola’s son, who “was not a licensed dentist” and often operated Floss without any licensed dentists present.
In late April, Gaviola’s co-conspirator as well as another clinic manager, Mia Diaz, 48, was sentenced to 21 months in prison.
Kickbacks were also given to marketers and caregivers of Medicaid-insured children to bring them to Floss for dental services.
Gaviola ultimately admitted to laundering money from the clinic’s bank account to his personal account, with several transactions exceeding $100,000. This went on from 2019-2021, with the clinic billing Medicaid nearly $6.9 million in claims, but Medicaid paid more than $4.9 million on these claims.
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The 68-year-old was previously released on bond but was taken into custody after the sentencing was handed down. Chief U.S. District Judge Crane also emphasized that Gaviola had failed to make any attempt to pay back restitution even though he has $2 million in assets stashed away in the Philippines.