A dentist in Florida has been accused by the Florida Attorney General’s Office and 58 patients of needlessly pulling children’s teeth in order to defraud Medicaid. This method of Medicaid fraud is known as overutilization. Overutilization is when a doctor performs unnecessary surgeries, test, or procedures in order to bill more money to Medicaid. The accused dentist has billed $4 million in four years to Medicaid by using this procedure.
In one incident, a mother took her daughter to Dr. Schneider to have one tooth pulled. Once she arrived at Dr. Schneider’s office a nurse asked the mother to remain in the lobby while her child was treated because, according to the nurse, “kids act better when parents aren’t in the room.” Three hours later, the nurse informed the mother her child was involved in an “incident.” When the mother saw her daughter she removed the gauze from her child’s mouth and discovered that rather than pull one tooth as requested, Dr. Schneider pulled seven of the little girl’s teeth.
Presently, this dentist has been served with 58 notices of intent to sue from parents.
Most of the public is not aware that Congress and many states have done something to deter defrauding Medicaid, and the government in general, through the False Claims Act. The False Claims Act has a qui tam (whistleblower) provision, which allows citizens to sue on behalf of the government when a party is committing fraud against the government. This helps our health care system in two major ways.
First, whistleblowers serve as a deterrent to fraud in the first place. Second, the government is recovering billions of tax dollars under the False Claims Act and every dollar the government recovers ensures that the money intended for health care is actually being spent on health care instead of needless procedures.
Under the False Claims Act, three times the amount of the damages and at least $5,500 in civil penalties per incident can be awarded. Additionally, whistleblowers are entitled to 15-30 percent of the amount the Government recovers as a reward.
The False Claims Act rewards those who step forward and tell the truth. Rewarding whistleblowers also rewards taxpayers by assisting the government in discovering fraud and recouping the taxpayers’ monies from fraudsters who are profiteering at the nation’s expense.
If you are aware of fraud being committed against the federal or state governments, you could be rewarded for doing the right thing and reporting the fraud. If you have any questions about whether you qualify as a whistleblower then please feel free to contact an attorney at Beasley Allen, for a free and confidential evaluation of your claim.
The attorneys in our qui tam practice group, Andrew Brashier, Larry Golston, Lance Gould and Archie Grubb, would be more than happy to discuss your potential case. They can be contacted at 800-898-2034 or 334-269-2343.