The Federal and Indiana State government recently announced that two dental firms agreed to pay more than $5.1 million to settle allegations that they submitted false claims to Indiana’s Medicaid program. ImmediaDent of Indiana, LLC, and its administrative services provider, Samson Dental Partners, LLC, were accused of billing straightforward tooth pullings as surgical operations and billing for deep cleanings that were either not required and/or performed. According to the settlement, Samson Dental Partners may have exerted improper influence on ImmediaDent staff in way that “compromised clinical judgment.”
The companies defended the quality of care provided to patients and noted that the claims involved services provided many years ago (2009-2013) under previous management. Their agreement to settle was described as a business decision that did not concede any wrongdoing. A former ImmediaDent dentist, acting as a whistleblower, initiated the suit and will receive $925,020 from the State of Indiana for his cooperation.
For dental providers, this case offers multiple takeaways to take note of, including:
- Enforcement authorities are continuing to scrutinize dental providers concerning overly aggressive billing practices
- DSOs and the clinicians they support must be scrupulous to avoid violating the corporate practice of dentistry prohibition
- Former employees who observed questionable billing practices may receive a financial windfall for their cooperation as qui tam relators in the prosecution of health care fraud and abuse
Contact Frier Levitt today to discuss the business and legal concerns of your dental practice and how our Dental Practice Group can help.