HARTFORD, Conn. (Legal Newsline) - Connecticut Attorney General George Jepsen and United States Attorney David B. Fein announced a settlement Tuesday with a New Haven dentist worth $212,000.
Kristi Rossomando and her dental practice, The Children's Dental Group P.C, allegedly took part in fraudulent Medicaid billing for certain pediatric dental services. The services included comprehensive oral evaluations, which is a service provided by dentists or specialists to new patients, established patients who have had a significant change in their health conditions or who have been absent from active treatment for three or more years.
Rossomando often did not see a new patient on his or her first visit, yet the practice billed Medicaid for a comprehensive oral evaluation, Jepsen alleged.
At the first visit at Children's Dental Group, children would usually only see a hygienist and the hygienist would then recommend a treatment and schedule a follow-up visit. Rossomando, however, would allegedly bill Medicaid for a comprehensive oral evaluation as if she had examined the patient and performed the service. Even on days when Rossomando was not in the office, Medicaid allegedly received regular billing for comprehensive oral evaluations.
A complaint against Rossomando was filed in the United States District Court in Connecticut under the qui tam, or whistleblower, provisions of both the state and federal False Claims Acts.
"It is unacceptable for a dentist to receive payment when no service is performed, or for a staff person to routinely render care that only a dentist is qualified to perform," Jepsen said. "The state will hold providers accountable for all services billed to Medicaid."
To settle the allegations under the state and federal False Claims Acts, the defendants agreed to pay $212,000, which covers conduct occurring from February 2005 through January 2011. Olivia Estrada, whose child had been treated by Rossomando, as the whistleblower, will receive a $31,800 share of the proceeds of the settlement.
The whistleblower provisions of both the federal and state False Claims Acts provide that the whistleblower is entitled to receive a percentage of the proceeds of any settlement or judgment recovered by the government.
In entering the civil settlement agreement, Rossomando and Children's Dental Group did not admit liability.