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Dental Company Settles Over Fraud In Medicaid

By Minara El-Rahman | Last updated on

This is definitely not news to smile about.

A dental company has recently settled claims over fraud in Medicaid billing with the United States Department of Justice. The press release by the DOJ has announced that FORBA Holdings LLC (which operates 69 clinics nationwide known as "Small Smiles Centers") will pay $24 million dollars, plus interest in order to settle claims of fraud in Medicaid billing for dental services allegedly provided to "low-income children that were either medically unnecessary or performed in a manner that failed to meet professionally-recognized standards of care."

According to ABC News, some of the unnecessary dental procedures were removing teeth, x-rays, and pulpotomies -- also known as baby root canals. I don't know about you, but root canals are painful enough when you need them. Imagine forcing poor kids to go through one they did not need?

The DOJ press release quotes Tony West, Assistant Attorney General for the Civil Division of the Department of Justice, as saying, "We have zero tolerance for those who break the law to exploit needy children. Illegal conduct like this endangers a child's well-being, distorts the judgments of health care professionals, and puts corporate profits ahead of patient safety."

While the settlement does not mean that the company admits guilt on any of these Medicaid fraud charges, the company has agreed to prevent any such fraud from taking place in the future. FORBA is quoted in a statement by ABC News as saying, "This comprehensive resolution encourages us to continue to focus on vital, high-quality dental care for children in America's low-income communities, and allows us to build on the improvements implemented since the company was acquired in September 2006."

I certainly hope that FORBA does hold itself to that statement. In the meantime, Daniel R. Levinson, Inspector General of the U.S. Department of Health and Human Services spoke of a zero tolerance for such bad business practices. He was quoted in the DOJ press release as saying: "Health care providers must be held accountable when they mistreat patients and overcharge insurers. We are committed to using our affirmative civil enforcement authority to protect patients from inadequate care and protect governmental health coverage programs from fraudulent charges."

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