Western Dental has been in a financial bind for some time, I would guess mainly due to the poor care, many complaints and most of all the OIG audit taking place. Then last week the OIG issued it's report on California's Denti-Cal program which indicated many Western Dentists has "Questionable Billing". Two days later, Western Dental issued a statement that they would no longer accept new Medicaid patients beginning June 1. citing low reimbursement from the state program. Hmmm... Sounds like an attempt to extort more money from California taxpayers and the Denti-Cal program to me. Apparently they need more money if they are to survive without "questionable billing". And who is right there campaigning for them... the California Dental Association. Didn't hear a thing from the CDA about the Questionable Billing Issue! Knock knock!! Anyone there...!!
Here is where I agree with the CDA, reimbursement rates need to be increase. But only and I mean ONLY when they get the massive amount of fraud stopped dead in it's tracks. Until then... no way!
Maybe Western Dental is still a little pissy about the 1997 raid.
California's largest dental HMO, already under state investigation for allegedly "shoddy" patient care, is now the focus of a federal criminal probe into insurance-fraud allegations made by former employees of Western Dental Services.
About a dozen investigators from the Federal Bureau of Investigation and the U.S. Postal Inspector's Office raided two Western Dental clinics Friday morning in the Sacramento area and hauled out boxes of medical records sought under court order.
Investigators were seeking evidence of what they believe to be "widespread overbilling" by Western Dental offices throughout California, according to an affidavit filed in U.S. District Court in Sacramento, a copy of which was provided to The Times. The court papers also say that federal investigators suspect the alleged insurance fraud scheme was carried out with the knowledge of Western Dental management and owners.