National dentistry chain Dental Dreams has agreed to pay the U.S. nearly $1.4 million to settle a whistleblower’s claims that it improperly billed the Massachusetts Medicaid program, MassHealth, for “unnecessary and unjustifiable dental procedures.”
The $1.375 million settlement resolves allegations brought by a former Dental Dreams employee under the whistleblower provisions of the False Claims Act (FCA), which allows private parties to sue on behalf of the U.S. government when witness to apparent fraud and other wrongdoing.
According to the U.S. Department of Justice (DOJ) the whistleblower lawsuit alleged that Dental Dreams overbilled the Massachusetts Medicaid program for surgical extractions of teeth and for a certain type of oral examination that was not specified.
“This dental chain’s extensive improper billing violated state regulations and cost our state’s Medicaid program more than a million dollars,” said Massachusetts Attorney General Maura Healey. “As a result of this joint investigation, today’s settlement provides restitution to MassHealth and ensures that these funds are properly used to benefit its members.”
Harold Shaw, Special Agent in Charge of the FBI’s Boston Field Division said that Dental Dreams “took advantage of a vulnerable patient population when it submitted claims to MassHealth for medically unnecessary and unreasonable dental procedures.”
“Today’s settlement underscores the FBI’s commitment to investigate health care providers who overbill federal and private health insurance programs to maximize profits,” he added. “We urge anyone with information regarding overbilling practices to contact us.”
Dental Dreams is a full-service chain of dentistry clinics that operate in ten states and the District of Columbia.
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Are you aware of fraud being committed against the federal government, or a state government? If so, you may be protected and rewarded for doing the right thing by reporting the fraud. If you have any questions about whether you qualify as a whistleblower, please contact an attorney at Beasley Allen for a free and confidential evaluation of your claim. There is a contact form on this website, or you may email one of the lawyers on our whistleblower litigation team: Archie Grubb, Larry Golston, Lance Gould or Andrew Brashier.
Source: U.S. Department of Justice