March 10, 2014
WASHINGTON – Senator Chuck Grassley, senior member and former Chairman of the Senate Committee on Finance, said the decision of the Inspector General for the Department of Health and Human Services to disqualify CSHM, LLC from the Medicaid program “will protect both taxpayers and vulnerable children receiving dental care in the Medicaid program.”
The Inspector General delivered a Notice of Exclusion (click here to read the Notice) following a year-long investigation by Grassley and then-Chairman Max Baucus of Montana into allegations of abusive treatment of children in clinics controlled by corporate investors rather than dentists. The senators issued a report and recommendations last July and urged the administration to ban dental clinics from participating in the Medicaid program if the dental clinics circumvent state laws designed to ensure only licensed dentists own dental practices to prevent substandard care.
“Our oversight found that when states can’t hold owners accountable, then clinics are more likely to fail to meet standards that protect the children who should be helped,” Grassley said. “The actions of some dental practices strained the Medicaid program and put low-income children in traumatic, highly questionable situations.”
The “Joint Staff Report on the Corporate Practice of Dentistry in the Medicaid Program” (click here to read the Report) released by Grassley and Baucus focused on dental management companies organized as a corporation or limited liability company that works with dentists in multiple states. The investigation found a failure to meet quality and compliance standards including unnecessary treatment on children, improper administration of anesthesia, providing care without proper consent, and overcharging the Medicaid program.
According to the report, while many clinics technically meet state-level rules requiring their owners to be licensed dentists, some clinics nonetheless placed control of their operations in the hands of corporate investors with the results placing “profits above patient care.” Twenty-two states and the District of Columbia ban corporate dentistry.
The Grassley-Baucus report also recommended that Medicaid be allowed to reimburse mid-level dental providers, such as dental therapists. Mid-level providers are in a position to provide much of the needed dental care at current Medicaid reimbursement rates.
“Access to dental services is a concern and empowering mid-level providers is a common sense solution,” Grassley said.