Paperwork mistakes is the number one excuse for fraud for heaven sake!
November 12
Maine DHHS could reduce fines for dentists
Dentists complain about large fines by an auditor for minor clerical errors in MaineCare patient cases.
By Joe Lawlor jlawlor@pressherald.com
Staff WriterThe Maine Department of Health and Human Services could reduce or eliminate the controversial fines recently levied against dentists serving MaineCare patients, according to a contract between the agency and the independent auditor who issued the penalties.
Dr. Michael Dowling works on Aiden Serber, 8, of Westbrook, as dental hygenist Trisha Drewry assists at Falmouth Pediatric Dentistry in Falmouth.
Gabe Souza/Staff Photographer
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Read Maine's contract with Health Management ServicesThe fines have been appealed and are in limbo awaiting DHHS rulings.
Dentists have complained to the Portland Press Herald that they were shocked to receive fines as large as $200,000 from new audits required under the federal Affordable Care Act. Statewide, the fines totaled about $800,000, and dentists have said they may have to close or sharply curtail services to low-income patients served under the MaineCare program if the fines are allowed to stand. The fines were based mostly on minor paperwork and coding errors, dentists have said, and the contract gives auditors financial incentives to penalize Medicaid providers for clerical errors.
“This has just been incredibly spiteful and petty,” said dentist Mark Zajkowski, of Oral and Maxillofacial Surgery Associates in South Portland. Zajkowski said his practice is facing a “substantial” fine. “The only thing this is going to do is disincentivize dentists serving MaineCare patients.”
While the ACA requires more comprehensive audits of Medicaid services, the specifics on how the audits are carried out and what types of penalties can be imposed are controlled by the states. In Maine, dental services are the first to be scrutinized by the new Medicaid audits, while hospitals are next on the list.
