Showing posts with label Mainecare. Show all posts
Showing posts with label Mainecare. Show all posts

Tuesday, November 12, 2013

Maine DHHS may reduce fines for dentists–No danger there!

Paperwork mistakes is the number one excuse for fraud for heaven sake! 


portand press

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
Staff Writer

The 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

Related Documents
Read Maine's contract with Health Management Services

The 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.