Bet’cha some these folks used to (or still does!) work for Small Smiles, Kool Smiles, Ocean Dental maybe… or one of the other Medicaid dental mills?
At least in Georgia, the police departments are using the tools in their toolbox. -O.C.G.A. Title 16, Section 16-5-70, Cruelty to Children. #dentalboardsareuselessinprotectingpatients
UPDATE December 4, 2012 – 9:42 AM
Office bills $13 million in Medicaid claims since ’08
by Lauren Jones, Staff Writer
After numerous allegations of child abuse and fraudulent activity flooded the Rome Police Department over the weekend, detectives are continuing their criminal investigation into Children’s Dentistry of Rome, officials said on Monday.
According to the search warrant affidavit filed in Floyd County Superior Court, MCG Management Inc., doing business as Children’s Dentistry of Rome, billed more than $13 million in Medicaid claims since 2008, and some victims and other dentists alleged that dental work provided by the doctors and hygienists was unnecessary.
Employees from the dentist office issued the following statement on Monday evening: “The dentists operating their practice at the MCG facility care about patients and provide quality care. Dental visits are not always pleasant, but we believe that the practitioners will be able to show they exercised sound judgment and compassion when treating young patients with significant dental problems.”Following complaints of improper use of restraints and improper or unnecessary performance of dental work on children, agents with the Department of Health and Human Services Office of the Inspector General and Rome Police Department investigators executed a warrant on Thursday and searched the office for billing and medical records pertinent to the criminal investigation.
No arrests have been made in the case and Rome police Lt. Gary Clayton declined to comment on the number of reports the detectives division has received.
The affidavit listed more than 300 patients with Medicaid whose records are being thoroughly investigated.
Medicaid claims
The affidavit, written by detective Joe Costolnick, lists 11 reports of excessive dentistry work performed on 14 children that resulted in serious medical problems and trauma. Reports recounted that children left the office traumatized, scratched and bruised.
Some children were allegedly tied down on papoose boards for unnecessary dental work, and some children needed additional medical attention for improperly done dental work they received at Children’s Dentistry of Rome.
Costolnick, who is specially trained with regard investigating criminal violations relating to cruelty and abuse to children, is working with Special Agent Connie Murray with the Department of Health and Human Services who investigates Health Care fraud.
Murray obtained a summary of the dental office’s Medicaid claims data from January 2008 to August 2012, the affidavit reported.
The Georgia Medicaid program provides health services to beneficiaries who qualify based on financial need or other circumstances.In providers’ contracts, the provider agrees to abide by state and federal laws when submitting claims and the Medicaid program requires that providers not bill for services not performed or delivered, and not to submit false or inaccurate claims.
Providers must maintain records to fully disclose the extent of services provided to members for a minimum of five years and the records must also explain the medical necessity for the services provided.
Since 2008, the company billed Medicaid for a total of
$13,407,134.34.
- $3,146,084.38 in 2008,
- $3,215,831.81 in 2009,
- $2,908,993.61 in 2010,
- $2,395,811.79 in 2011
- $1,740,412.75 as of August of 2012
Unnecessary dental work?
In the affidavit, some reports by parents of children who received dental work at Children’s Dentistry of Rome claimed that children went in to the office for routine checkups but left having had more dental work performed, as well as traumatized and in tears.
