Bilal Ahmed, 47, of Potomac, Maryland, pled guilty on September 6, 2019, to a federal charge of healthcare 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 Honorable Judge Colleen Kollar-Kotelly has scheduled sentencing for January 17, 2020.
Ahmed was indicted in January 2019 along with his former office manager on one count of conspiracy to commit healthcare fraud, one count of healthcare fraud, and five counts of wire fraud. He pled guilty in the US District Court for the District of Columbia to Count II of the Indictment. 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 he currently is serving for sexually assaulting five former patients and one former employee and improperly touching another former employee in separate incidents between 2010 and 2014, that request is not binding on the court.
According to the statement of offense submitted to the court, Ahmed was a practicing dentist who owned and Universal Smiles, a dental practice in Northwest Washington, DC. When the DC Dentistry Board suspended his license in 2014 and he surrendered it, he 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 Washington, DC. Through Universal Smiles and DES, Ahmed and his office manager engaged in a scheme to enrich themselves by defrauding DC Medicaid, which is jointly funded by the federal government and the District of Columbia.
As part of the scheme, with the assistance of the office manager, Ahmed 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 DC Medicaid for thousands of provisional crowns that were not provided to the Medicaid patients and shared the fraud proceeds. From August 9, 2012, to February 26, 2014, DC Medicaid paid Universal Smiles approximately $12.4 million. From November 17, 2014, to February 1, 2016, DC Medicaid paid DES about $1.2 million.
Of the more than $13 million that DC Medicaid paid to Universal Smiles and DES, about $5.4 million was for provisional crowns. Of the $5.4 million that DC Medicaid paid for provisional crowns, Ahmed obtained approximately $4 million from the fraudulent scheme, and the office manager obtained approximately $1.4 million.