Paxton’s Medicaid fraud control unit secures indictment in $6.9 million Medicaid scheme

Paxton’s Medicaid Fraud Control Unit Helps Secure Indictment Against Two Individuals Accused of...
Paxton’s Medicaid Fraud Control Unit Helps Secure Indictment Against Two Individuals Accused of $6.9 Million Medicaid Fraud and Kickback Scheme(The Texas Attorney General)
Published: Aug. 29, 2022 at 2:39 PM CDT
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AUSTIN, Texas (NEWS RELEASE) - An investigation by the Texas Attorney General’s Medicaid Fraud Control Unit, the FBI, Department of Health and Human Services - Office of the Inspector General, and Customs and Border Protection has led to charges being brought against two Houstonians for their role in a nearly $6.9 million Medicaid fraud and kickback scheme.

Ifeanyi Ndubisi Ozoh, 51, and Rene Fernandez Gaviola, 65, acted as manager and operator, respectively, of Floss Family Dental Care clinic in Houston. From 2019 through 2021, Floss billed Medicaid for nearly $6.9 million while receiving payments of approximately $4.9 million.

Both Ozoh and Gaviola have been brought into custody and face charges after a federal grand jury returned a 13-count indictment on August 16.

Federal authorities allege that they made false and fraudulent claims to Medicaid for dental services that were never provided. The indictment also charges Gaviola and Ozoh for potential kickbacks paid to marketers and caregivers of children to bring them to Floss.

Gaviola also faces charges for employing and billing Medicaid for a person practicing pediatric dentistry without a license, and for laundering over $100,000 in Medicaid monies from the Floss business bank to his personal account.

For the charges of health care fraud, conspiracy to commit health care fraud, and money laundering, Gaviola is facing up to 10 years in prison on each count, and a $250,000 maximum possible fine. Ozoh and Gaviola also both face up to an additional 5 years in federal prison and a $250,000 maximum possible fine for conspiracy to pay and receive kickbacks.