Medicaid dental investigation leads to raids of offices in six states

On October 18th, federal officials raided dental offices in Florida, Iowa, Michigan, Pennsylvania, Ohio and South Carolina.

Oberheiden, P.C., a healthcare law firm with a nationwide footprint that routinely represents dentists and other healthcare professionals in Medicaid and Medicare fraud claims learned from a confidential source that on October 18th federal authorities raided dental offices in Florida, Iowa, Michigan, Pennsylvania, Ohio and South Carolina in a sweeping investigation into fraudulent billing practices targeting Medicaid.

The raids reflect the government’s continued commitment to aggressively combating fraud, waste, and abuse targeting healthcare benefits programs.

It is not uncommon for a dental practice to rely on Medicaid to subsidize income from patients with private insurance. Many who do not have access to healthcare rely on Medicaid for themselves and their children so that they can regularly see a doctor. States are required to include dental in benefits available to children on Medicaid while states can choose to opt-in for adults.

For the past few years, dentists and other healthcare professionals have faced enhanced government scrutiny. Different programs automate the review of billing data by such authorities as the U.S. Department of Justice (DOJ); audits conducted by FFS contractors working with the Centers for Medicare and Medicaid Services (CMS); investigations by the DOJ, the U.S. Department of Health and Human Services’ Office of the Inspector General (OIG), as well as other federal agencies and task forces.

Jesse Barron is the Executive Editor of DSO News. He is also a Managing Partner of Dental Allies, Inc. Dental Allies helps practices and dental businesses scale. They accomplish this by focusing their clients on culture, growth, automation and operational improvement. They are partnered with the processing affiliate of a bank to provide the lowest payment processing rates in dental. They’ll introduce you. They are big on making meaningful introductions. Dental Allies delivers results that are real, impactful and meaningful. He feels most challenged and content when automating a previously manual process.