Dentist Pleads Guilty to Illegally Obtaining Medicaid Funds and Paying Recruiters to Refer Medicaid Beneficiaries to His Dental Practice in Exchange for Bribes | USAO-MD

green belt, Maryland – Edward T. Buford III, 70, of Silver Spring, Maryland, pleaded guilty on May 4, 2022 to conspiracy to commit mail fraud and health care fraud. As part of his guilty plea, Buford will have 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, Bureau of Investigations, Office of the 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 of 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, in receiving fraudulently obtained Medicaid funds, and recruiting Medicaid beneficiaries to fund the program by paying kickbacks and kickbacks.

Buford was a licensed dentist in Washington, D.C. and the owner and managing director of International Dental Associates, Inc. (IDA), a dental clinic located in Washington, D.C. Prior to 2015, Buford was registered as a Medicaid provider, however, in April 2015, Medicaid suspended payments to Buford under its provider number.

After Buford’s provider number was suspended in 2015, Buford and his business partner/IDA director (co-conspirator 1) continued to submit Medicaid claims through the IDA provider number. In April 2016, Buford and co-conspirator 1 re-registered IDA as a Medicaid provider. In the IDA request, Buford and co-conspirator 1 did not disclose Buford’s suspension from Medicaid.

Buford and his co-conspirators caused Buford and the IDA to submit Medicaid claims for a variety of dental services, including dentures. As part of the conspiracy, Buford and co-conspirator 1 offered and paid bribes to co-conspirator 2 and other patient recruiters in exchange for referring Medicaid beneficiaries to IDA for dental services, even though Medicaid wouldn’t pay the claims if it knew they were purchased. by bribes. Medicaid paid significantly more for dentures than for many other dental services, including dental cleanings, and Buford and co-conspirator 1 paid co-conspirator 2 larger kickbacks for beneficiaries who accepted to be fitted with prostheses – approximately $50 per beneficiary – than for beneficiaries who only agreed to receive dental cleanings.

Under the direction of Buford and co-conspirator 1, co-conspirator 2 offered Medicaid recipients cash bribes to entice them to visit and accept IDA dental services. Buford and his co-conspirators generally paid higher amounts to recipients who agreed to be fitted with dentures than to those who only agreed to receive cleanings. Even though the dentures required multiple visits to be fitted and delivered, Buford and his co-conspirators only paid recipients for the initial visit—after which Buford and his co-conspirators could bill Medicaid for the dentures—and to many beneficiaries never returned to IDA after receiving the cash bribe. As a result, Buford and his co-conspirators stored hundreds of undelivered dentures on IDA premises, many of which had been billed and paid for by Medicaid.

As part of the fraud scheme, Buford maintained a PO Box in Silver Spring, Maryland as IDA’s billing address and received the funds fraudulently obtained there. For example, on September 21, 2017, Buford instructed Medicaid to mail a check for $17,397 to the Maryland PO Box for services allegedly provided to 11 Medicaid beneficiaries.

Based on the amount Medicaid paid Buford and IDA for the prostheses that were not delivered, the actual loss to Medicaid was at least about $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 health care fraud. U.S. District Judge Theodore D. Chuang set sentencing for August 3, 2022 at 9:00 a.m.

United States Attorney Erek L. Barron commended the FBI, HHS-OIG, Office of the Inspector General of Medicaid Fraud Enforcement 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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