Medicaid Fraud

Washington, DC: (Apr-09-08) The United States and the state of North Carolina brought charges against Medicaid Dental Center (MDC), a privately-owned chain of dental clinics in North Carolina previously known as Smile Starters and Carolina Dental Center, alleging that it caused false or fraudulent claims for payment to the North Carolina Medicaid program by billing for medically unnecessary dental services performed on indigent children.

The suit named MDC and its ownership, including Michael A. DeRose, DDS, P.A., and Letitia L. Ballance, DDS, as defendants, stating that they were liable under the False Claims Act. The suit said that the establishment performed unnecessary pulpotomies and submitted claims for reimbursement. Additionally, the defendants were charged with submitting claims for reimbursement for placing stainless steel crowns that were not medically necessary and for failing to obtain informed consent for all medical procedures and services.

As part of a settlement reached in the case, MDC agreed to pay $10,050,000 to resolve allegations. Federal officials said that the settlement is limited to claims submitted to the North Carolina Medicaid program and does not involve any other states. As per court records, 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. [STREET INSIDER: NORTH CAROLINA DENTAL SERVICES CHAIN PAYS $10 MILLION TO RESOLVE FALSE CLAIM ALLEGATIONS]