North Carolina Attorney Lawyer

WASHINGTON, April 9, 2008 / PRNewswire-USNewswire / - Medicaid Dental Center (MDC), a privately-owned chain of dental clinics in North Carolina Starters previously known as Carolina and Smile Dental Center, has reached a settlement with the United States and North Carolina to resolve allegations False Claims Act, the Justice Department announced today. Under the agreement, MDC agreed to pay $ 10050000 to resolve allegations that it caused false or fraudulent claims for payment to be presented to the North Carolina Medicaid program by billing for unnecessary dental medical services performed on indigent children.
The United States and the state of North Carolina that the MDC and its ownership, including Michael A. DeRose, DDS, PA, L. And Letitia Ballance, DDS, were liable under the False Claims Act for submitting claims for reimbursement for performing pulpotomies that Médicaux were not necessary. Medical Pulpotomies are considered necessary in cases when pediatric dental infection spreads in a tooth into the pulp chamber of the tooth, requiring the pulp’s removal. This procedure is often referred to as a “baby root canal.
MDC and its appropriation by were also claims to have submitted for reimbursement for placing medical stainless steel crowns that were not necessary and for failing to obtain informed consent for all medical procedures and services. The settlement is limited to claims submitted to the North Carolina Medicaid program and does not involve any other states.
“These dentists submitted their child to invasive for patients and sometimes painful procedures, often for the sake of obtaining money from the North Carolina Medicaid program,” said Jeffrey S. Bucholtz, the acting Assistant Attorney General for the Department’s Civil Division.
Both Dr. Dr. Ballance DeRose and have been disciplined by the North Carolina Board of Dental Examiners. Both consent orders entered into with the Board on December 8, 2005. Under the terms of these consent orders, each of the dentists agreed not to contest allegations that dentists trained and employed by MDC excessive treatment performed on seven of MDC’s pediatric patients by performing pulpotomies and placing stainless steel crowns when they were not warranted or supported by x — Rays diagnosis or appropriate documentation. As part of today’s settlement, Office of the Inspector General for the US Department of Health and Human Services has expressed its exclusion reserved authority and against MDC Drs DeRose and Ballance.
“Health care professionals who abuse their positions and engage in excessive treatment regimens and excessive billing practices will not be tolerated,” said Gretchen CF Shappert, US Attorney for the Western District of North Carolina. “The North Carolina Medicaid Program was not created for self-enrichment. It is a public trust. Individuals who use their professional skills to take advantage of trust that will be investigated and held to account for their actions.”
“This settlement with the Medicaid Dental Center demonstrates the commitment of the Office of Inspector General and our law enforcement partners to protect our nation’s children,” said Daniel R. Levinson, Inspector General of the US Department of Health and Human Services. “The Medicaid program is intended to assist the most vulnerable Americans and to help ensure that they receive necessary health services, not to unjustly enrich others at the expense of indigent persons.”
The investigation and settlement of the case was conducted by the US Attorney’s Office for the Western District of North Carolina and the Department’s Civil Division, along with the Federal Bureau of Investigation, the US Postal Service’s Office of Postal Inspection, the Department of Health and Human Services Office of Inspector General, and the North Carolina Attorney General’s Medicaid Fraud Investigations Unit.