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Wednesday, February 26, 2020

Washington AG reaches settlement with Sea Mar Health Centers for alleged Medicaid misbilling

By Mark Payne | Jan 19, 2015

Washington Attorney General Bob Ferguson | Washington Attorney General's Office

Sea Mar Health Centers will pay a $3.35 million settlement after it allegedly overcharged dental patients and Medicaid in Washington state, according to an announcement today by Washington Attorney General Bob Ferguson.

Sea Mar would allegedly bill customers for services, such as fluoride treatments, as full appointments. Instead, the treatments should have been a part of the normal six-month visits, as the treatments can be performed by dental assistants. The company overcharged on bills to Medicaid in the amount of over $3 million for services that were rendered from 2010 to 2014.

“Without exception, providers who participate in our state’s Medicaid program must accurately bill for and document services provided,” Ferguson said. “I’m pleased my office was able to recover the excess taxpayer funds that went out the door so this money can go back into health care for those in need.”

The attorney general alleges that fluoride treatments are typically a charge that appears on a bill, and usually costs between $13 and $24. However, Sea Mar was allegedly charging full visits for the treatment, which totaled around $180. Sea Mar also allegedly charged for appointments that went over Medicaid’s limit for dental exams, according to claims from the Washington False Claims Unit.

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Washington State Attorney General