WASHINGTON (Legal Newsline) — The U.S. Department of Justice announced Jan. 10 that Benevis LLC, a dental management company, and more than 130 of its affiliated Kool Smiles dental clinics will pay $23.9 million after allegations of submitting false claims to state Medicaid programs for child dental services that were not medically needed.

“Billing Medicaid programs for dental procedures that are not necessary contributes to the soaring costs of healthcare,” said acting assistant attorney general Chad A. Readler of the Justice Department’s Civil Division.  “When health care providers put vulnerable patients at risk by performing medically unnecessary procedures to achieve financial goals, we will take action.”  

Kool Smiles clinics managed by Benevis throughout 17 states, allegedly violated the False Claims Act between January 2009 and December 2011. During that time, the defendants purportedly performed pulpotomies—baby root canals—in a multitude of situations in which the procedure was unnecessary. According to the Justice Department, the defendants billed Medicaid programs for these services.

“When providers accept federal funds for reimbursement, they have a duty and responsibility to provide the best care possible to the patient, especially when their patients are economically disadvantaged children,” said U.S. attorney Ryan K. Patrick for the Southern District of Texas.

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