Former Connecticut Dentist Ordered To Pay $700k For Medicaid Billing Scheme
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On August 11, 2016, a former dentist in Connecticut and his practice were ordered to pay more than $700,000 in restitution and civil penalties for improperly billing the state Medicaid program for pediatric dental cleanings and fluoride treatments.
Connecticut Attorney General George Jepsen says a Superior Court judge ruled that Dr. Douglas Macko and his practice violated the Connecticut Unfair Trade Practices Act.
A Scheme to Improperly Bill Medicaid.
According to Jepsen, Dr. Macko allegedly devised and implemented a scheme to improperly bill the state’s Medicaid program for pediatric dental cleanings and fluoride treatments. Under law, these treatments can only be given by licensed dentists or licensed dental hygienists. Dr. Macko purportedly let unlicensed assistants and sometimes even the patients or their parents conduct the service.
“We want to make it clear that professionals who step over the line and take advantage of taxpayers and consumers in Connecticut will suffer the consequences,” said Jonathan Harris, commissioner of the Department of Consumer Protection. “Ensuring public health and safety is our number one priority.”
To read about a similar case of improper billing, click here to read one of my prior blogs.
To learn more about Medicare Audits and Investigations, click here to visit our website.
Similar Medicaid Problems In Florida.
Unfortunately, we have also been called on to represent a number of dentist and oral surgeons here in Florida with similar types of problems with the Florida Medicaid Program. In one case we are currently defending, Medicaid is demanding repayment of over $3 million dollars.
It is very important for any dentist who accepts Medicaid to have a good working relationship with an experienced health attorneys and an experienced dental consultant. And there are not that many of either here in Florida. At the first sign of any type of audit or inspection by Medicaid or an insurance company, a dentist or oral surgeon needs to get an experienced attorney involved. I hate to say it, but it seems to me like the Florida Medicaid Program is intentionally trying to eliminate all dentists who accept Medicaid.
Don’t Wait Until It’s Too Late; Consult with a Health Law Attorney Experienced in Medicaid Billing Issues Now.
The attorneys of The Health Law Firm represent dentists, oral surgeons, and other health care providers in Medicaid audits, Medicare audits, insurance billing audits, ZPIC audits, RAC audits, administrative litigation and civil litigation throughout Florida and across the U.S. They also represent physicians, medical groups, nursing homes, home health agencies, pharmacies, hospitals and other healthcare providers and institutions in licensure complaints and investigations, DEA investigations, Medicare and Medicaid fraud investigations, audits, recovery actions and terminations from the Medicare or Medicaid Program.
For more information please visit our website at www.TheHealthLawFirm.com or call (407) 331-6620 or (850) 439-1001.
“Ex-Dentist Ordered To Pay $700k For Medicaid Billing Scheme.” The Associated Press. (August 11, 2016). Web.
About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.
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