Consumer Fraud

Whistleblower Helps Recover $5.1 Million In Medicaid Funds From Indiana Dental Chain

Pills Stethascope on Money 435x289 Whistleblower Helps Recover $5.1 Million In Medicaid Funds From Indiana Dental ChainA whistleblower who sued an Indiana-based dental chain and its Kansas-based management company has helped the U.S. and Indiana recover $5.1 million in Medicaid funds.

The whistleblower lawsuit named ImmediaDent of Indianapolis and Samson Dental Partners, LLC, which provided administrative services to the dental chain, as defendants. The complaint alleged that the companies submitted false claims to Medicaid by improperly billing tooth extractions as more costly surgical extractions, the U.S. Attorney’s Office for the Western District of Kentucky said in an announcement of the settlement.

The whistleblower’s complaint also accused ImmediaDent and Samson of billing Medicaid for “deep cleanings” that were never provided or weren’t necessary.

Samson also violated an Indiana law prohibiting a corporate dentistry practice of improperly influencing ImmediaDent’s medical professionals and staff by rewarding production, disciplining employees for not meeting production objectives, and directing personnel in a manner which compromised clinical judgment, the U.S. Attorney’s office alleged.

Upon investigating the whistleblower’s False Claims Act allegations, federal prosecutors determined that the unlawful activity occurred over a period of nearly five years starting in January 2009.

The defendants agreed to pay the U.S. $3.4 million and the state of Indiana $1.78 million to settle the whistleblower lawsuit. In connection with the settlement, the Department of Health and Human Services’ Office of Inspector General determined that both companies needed closer regulatory scrutiny and proposed they enter into a Corporate Integrity Agreement requiring additional oversight, compliance measures, and monitoring.

The companies refused to enter into the agreement, and federal regulators said because of their refusal, the companies “pose a continuing high risk to the Federal health care programs and their beneficiaries.”

Dr. Jihaad Abdul-Majid filed the lawsuit against ImmediaDent and Samson under the whistleblower provisions of the False Claims Act. Dr. Abdul-Majid will be entitled to collect a whistleblower award of up $1.275 million for his role in helping the U.S. and the state recover the Medicaid funds.

“Working to recover taxpayer funds taken through fraud and other illegal means is part of our responsibility as stewards of the public trust,” said Indiana Attorney General Curtis Hill, who helped prosecute the case. “We appreciate the collaboration of our federal partners in this particular case and we intend to remain vigilant going forward to make sure Medicaid monies are used for their designated purposes.”