Dentist Pleads Guilty to Unlawfully Obtaining Medicaid Funds and Kickbacks

LegalImage by Mike Braun

GREENBELT, MD — Edward T. Buford III, age 70, of Silver Spring, Maryland, pleaded guilty on May 4, 2022, to conspiracy to commit mail fraud and healthcare fraud. As part of his guilty plea, Buford will be required to pay $1,267,630 in restitution.

The guilty plea was announced by United States Attorney for the District of Maryland Erek L. Barron; Special Agent in Charge Wayne Jacobs of the Federal Bureau of Investigation – Washington Field Office Criminal Division; Special Agent in Charge Maureen Dixon, Office of Investigations, Office of Inspector General of the Department of Health and Human Services; Special Agent in Charge Michael McGill of the Social Security Administration – Office of Inspector General, Philadelphia Field Division; and Daniel W. Lucas, Inspector General for the District of Columbia.

According to his guilty plea, from January 2013 to May 2018, Buford and others devised and executed a scheme to defraud Medicaid for the District of Columbia by filing fraudulent Medicaid claims for dental services to Medicaid beneficiaries, receiving the fraudulently obtained funds from Medicaid, and recruiting Medicaid beneficiaries to fuel the scheme through the payment of kickbacks and bribes.

Buford was a licensed dentist in Washington, D.C. and the owner and Chief Executive Officer of International Dental Associates, Inc. (IDA), a dental clinic located in Washington, D.C.  Before 2015, Buford was enrolled as a Medicaid provider, however, in April 2015, Medicaid suspended payments to Buford under his provider number.

After Buford’s provider number was suspended in 2015, Buford and his business partner/IDA manager (Co-conspirator 1) continued to submit claims to Medicaid through IDA’s provider number.  In April 2016, Buford and Co-conspirator 1 re-enrolled IDA as a provider in Medicaid.  Within IDA’s application, Buford and Co-conspirator 1 failed to disclose Buford’s suspension from Medicaid.

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Buford and his co-conspirators caused the submission of Medicaid claims by Buford and IDA for a variety of dental services, including dentures.  As part of the conspiracy, Buford and Co-conspirator 1 offered and paid kickbacks to Co-conspirator 2 and other patient recruiters in exchange for referring Medicaid beneficiaries to IDA for dental services, even though Medicaid would not pay claims had it known they were procured through kickbacks.  Medicaid paid substantially more for dentures than for many other dental services, including dental cleanings, and Buford and Co-conspirator 1 paid Co-conspirator 2 larger cash kickbacks for beneficiaries that agreed to be fitted for dentures—approximately $50 per beneficiary—than for beneficiaries who only agreed to receive dental cleanings.

At Buford and Co-conspirator 1’s direction, Co-conspirator 2 offered Medicaid beneficiaries cash bribes to induce them to visit and accept dental services from IDA.  Buford and his co-conspirators typically paid higher amounts to beneficiaries who agreed to be fitted for dentures than those who only agreed to receive cleanings.  Even though dentures required multiple visits to fit and deliver, Buford and his co-conspirators paid the beneficiaries only for the initial visit—after which Buford and his co-conspirators could bill Medicaid for the dentures—and numerous beneficiaries never returned to IDA after receiving the cash bribe.  Accordingly, Buford and his co-conspirators stored hundreds of undelivered dentures on IDA’s premises, many of which had been billed to and paid for by Medicaid.

As part of the scheme to defraud, Buford maintained a Post Office box in Silver Spring, Maryland as IDA’s billing address and received the fraudulently obtained funds at that location.  For example, on September 21, 2017, Buford caused Medicaid to mail a check for $17,397 to the Maryland P.O. box for services purportedly provided to 11 Medicaid beneficiaries.

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Based on the amount that Medicaid paid to Buford and IDA for dentures that were not delivered, the actual loss to Medicaid was at least approximately $1,267,630.

Buford faces a maximum sentence of 20 years in federal prison followed by 3 years of supervised release for conspiracy to commit mail fraud and healthcare fraud.  U.S. District Judge Theodore D. Chuang has scheduled sentencing for August 3, 2022, at 9:00 a.m.

United States Attorney Erek L. Barron commended the FBI, HHS-OIG, the D.C. Office of the Inspector General’s Medicaid Fraud Control Unit, SSA-OIG for their work in the investigation.  Mr. Barron thanked Assistant U.S. Attorneys Jessica C. Collins and Rajeev R. Raghavan, who are prosecuting the case.

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