Company Affiliated with East Texas Dentist Locations Settles on Nearly $24 Million Payment
When you can't even trust your doctor, dentist, or any professional that you rely on for your well-being, it's a sad day. KETK, also known as East Texas Matters, reported on Wednesday (Jan. 10) that a management company affiliated with multiple East Texas dentist locations has settled to pay $23.9 million to the federal government and participating states.
There are four locations in East Texas - two in Longview, one in Tyler and one in Lufkin.
According to Hartford Business, the company, which manages 133 dental clinics in 17 states as Kool Smiles Dentistry, was allegedly performing unnecessary dental work on needy children. Specifically, children under Medicaid.
In the press release from the US Justice Department, Acting Assistant Attorney General Chad A. Readler said:
When healthcare providers put vulnerable patients at risk by performing medically unnecessary procedures to achieve financial goals, we will take action.
The release continues to explain that between January of 2009 and December of 2011, Benevis and Kool Smiles clinic "knowingly submitted false claims to state Medicaid programs for medically unnecessary baby root canals, tooth extractions and stainless steel crowns". They were also caught seeking payments for root canals that were never even performed.
Here's how the $23.9 million settlement will be broken down per the Justice Department:
Of the $23.9 million to be paid by Benevis and its affiliated Kool Smiles clinics, the federal government will receive a total of $14,244,073.49, plus interest, and a total of $9,655,926.51, plus interest, will be returned to individual states, which jointly funded improper claims submitted to state Medicaid programs.
By doing this, this company hurts the medical industry, but really... it hurts the civilian population. I'm no Poli-Sci expert, but if this continued (or continues), other companies would want to try it out.
Hence the very strong punishment. U.S. Attorney John F. Bash for the Western District of Texas said:
Today’s settlement sends a very clear signal: Fraud in the federal healthcare system will not be tolerated. Especially when that fraud involves performing unnecessary procedures on kids.
Kool Smiles did make a statement later Wednesday, which begins as such:
Benevis, and its affiliate Kool Smiles, have voluntarily entered into a settlement with the U.S. Department of Justice (DOJ) and various State Attorneys’ General to end the government’s seven-year long False Claims Act (FCA) investigation relating to services provided from 2009 to 2011.
The settlement agreement with the government does not relate to any claims regarding the quality of the dental care provided to patients. Importantly, the settlement does not include any admission or determination of wrongdoing by the companies, their employees or any Kool Smiles dentists. In fact, the companies strongly disagree with the government’s allegations.
You can read the rest of their press release here.