Texas And U.S. Receive $8.45M To Settle Dental Fraud Allegations

162017_132140396847214_292624_nOn January 9, 2017, the U.S. Attorney’s Office for the Northern District of Texas announced that Texas-based MB2 Dental Solutions (MB2) and 21 pediatric dental practices affiliated with MB2, along with their owners and marketing chief, have agreed to pay the United States and the State of Texas Medicaid program $8.45 million to resolve allegations that they violated the False Claims Act by knowingly submitting, or causing the submission of, claims for pediatric dental services that were not rendered, were tainted by kickbacks, or falsely identified the person who performed the service.

The settlement resolves allegations that between January 1, 2009 and December 31, 2014, MB2 and affiliated dental practices submitted claims to the Texas Medicaid Fee for Service Program for single-surface fillings in children that were not provided. The settlement also resolves allegations that MB2 paid kickbacks to Medicaid beneficiaries and their families, marketers, and marketing entities, in violation of the Anti-Kickback Statute, and that MB2 and affiliated dental practices used erroneous Medicaid provider numbers misrepresenting the dentists performing the pediatric procedures.

As part of the settlement, MB2 and others entered into a five-year Corporate Integrity Agreement (CIA) with the Department of Health and Human Services Office of Inspector General (HHS-OIG). The CIA requires an independent review organization to annually assess whether claims reimbursed by a federal health care program were correctly coded, medically necessary, and appropriately documented.

MB2 is a dental management firm based in Carrollton, Texas that provides management services to affiliated dental offices. The dental practices included in the settlement are Dental Professionals of Texas PLLC; Archstone Dental PLLC; Bliss Dental PLLC; Crescent Dental PLLC; Dental Central PLLC; Dental Family Circle PLLC d/b/a Forney Wellness Dental; DFW Family Dental Centers PLLC; Element Dental PLLC; Fresh Dental PLLC; Galaxy Dental PLLC; Legend Dental PLLC; Peppermint Dental PLLC; Picasso Dental PLLC; Sage Dental PLLC; Spearmint Dental PLLC; Tide Dental PLLC; Vida Dental PLLC; Viva Orthodontics PLLC; and, Wow Dental PLLC.

Part of the allegations resolved by the settlement were originally filed under the qui tam provisions of the False Claims Act (Act) by Veronica Garcia, a former MB2 employee. The Act permits private parties to sue on behalf of the government for false claims for government funds and to receive a share of any recovery. Ms. Garcia will receive $1.521 million from the United States and the State of Texas.

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The settlement was as a result of the whistleblower filing three lawsuits, one lawsuit under the Act and two under the Texas Medicaid Fraud Prevention Act (TMFPA). As a result of the settlement, the State of Texas will receive approximately $4.2 million of the settlement proceeds.

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If you have information regarding false claims having been submitted to Medicare, Medicaid, TRICARE, other federal health care programs, or to other federal agencies/programs, and the information is not publically known and no actions have been taken by the government with regard to recovering the false claims, you should promptly consult with a False Claims Act attorney (also known as qui tam attorneys) in your U.S. state who may investigate the basis of your False Claims Act allegations and who may also assist you in bringing a qui tam lawsuit on behalf of the United States, if appropriate, for which you may be entitled to receive a portion of the recovery received by the U.S. government.

Click here to visit our website or call us toll-free in the United States at 800-295-3959 to be connected with qui tam lawyers (False Claims Act lawyers) in your U.S. state who may assist you with a False Claims Act lawsuit.

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This entry was posted on Tuesday, January 24th, 2017 at 5:16 am. Both comments and pings are currently closed.

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