LOUISVILLE, Ky. – United States Attorney Russell M. Coleman announced today that ImmediaDent of Indiana, LLC (ImmediaDent), which operates nine dental care practices in Indiana, and Kansas based Samson Dental Partners, LLC (SDP), which provides administrative support services to ImmediaDent, have agreed to pay the United States and the State of Indiana $5.139 million to resolve allegations that they improperly billed Indiana’s Medicaid program for dental services; the companies have been determined to continue to be a high risk to the United States health care programs and their beneficiaries.
The settlement comes as part of a coordinated effort between the United States Attorney’s Office in the Western District of Kentucky, working on behalf of the Office of Inspector General (OIG) of the Department of Health and Human Services, and the Office of the Indiana Attorney General, Medicaid Fraud Control Unit.
“Let this be a warning to health care organizations that the United States government is watching, and will continue to watch for false claims no matter how large or small,” said United States Attorney Russell M. Coleman. “The United States Attorney’s office is protecting the taxpayers’ dollars every day with the help of our state and local partners.”
The companies are accused of submitting false claims for payment to Indiana’s Medicaid program between January 1, 2009, and September 30, 2013. Both companies are alleged to have submitted false claims to Indiana’s Medicaid program by (1) improperly billing simple tooth extractions as though they were surgical extractions and (2) improperly billing Scale and Root Planings (otherwise known as “deep cleanings”) that were either not performed or not medically necessary. Additionally, SDP is accused of violating Indiana’s law prohibiting the corporate practice of dentistry by improperly influencing ImmediaDent’s medical professionals and staff by rewarding production, disciplining employees for not meeting production objectives, and directing personnel in a manner which compromised clinical judgment.
SDP and ImmediaDent agreed to pay the United States $3,400,270.74 under the settlement. The companies also agreed to pay $1,782,729.26 to the state of Indiana. In connection with this settlement, OIG determined that the companies needed additional oversight. OIG proposed the companies enter into a Corporate Integrity Agreement that would require compliance measures and monitoring by OIG. The companies refused to agree to this oversight. OIG has determined that in the absence of such oversight, the companies pose a continuing high risk to the Federal health care programs and their beneficiaries.
“Working to recover taxpayer funds taken through fraud and other illegal means is part of our responsibility as stewards of the public trust,” said Indiana Attorney General Curtis Hill. “We appreciate the collaboration of our federal partners in this particular case and we intend to remain vigilant going forward to make sure Medicaid monies are used for their designated purposes.”
This matter arose as a complaint for monetary damages under the qui tam provisions of the federal False Claims Act and Indiana’s False Claims Act. The relator, Dr. Jihaad Abdul-Majid, filed a qui tam action on February 20, 2013, in the United States District Court for the Western District of Kentucky captioned United States ex rel. Jihaad Abdul-Majid, et al. v. ImmediaDent Specialty, P.C., et al., Civil Action No. 3:13-cv-222-CRS.
Assistant United States Attorney Benjamin S. Schecter handled the case for the United States in coordination with Indiana Deputy Attorney General Lawrence J. Carcare II. The Department of Health and Human Services Office of Inspector General, Defense Criminal Investigative Services, and the Indiana Attorney General’s Medicaid Fraud Control Unit assisted in the investigation.