UPDATE: TDMR has received a copy of the ImmediaDent and Samson Partners press statement from Samson Partners vice-president of marketing Stephen Valenti. It is at the bottom of our story in full.
Largest dental Medicaid provider in three states
ImmediaDent has nine offices in the state and a total of 33 locations in Indiana, Kentucky and Ohio. According to a statement to Louisville Business First from Stephen Valenti, vice president of marketing for Samson Dental, ImmediaDent is the largest dental provider to Medicaid patients in those three states.
Allegedly submitted false billings
The accused companies allegedly improperly billed Indiana’s Medicaid program for dental services. Specifically, according to the DOJ press release:
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.
Companies maintain they did nothing wrong
However, Valenti, in his statement to the media, says:
"The settlement agreement that Samson and ImmediaDent have entered into is not a concession of any wrongdoing by Samson Dental Partners or ImmediaDent, their employees or dentists. To the contrary, the companies strongly disagree with the assertion that they knowingly did anything improper.
"However, after almost four years of litigation and significant expense already incurred, the companies have concluded that their collective energies are better focused on continuing their expansion efforts, and working to provide the best care possible to patients."
Whistleblower was fired back in 2012
The original allegations of Medicaid fraud were made by Dr. Jihaad Abdul-Majid who filed a qui tam action back on February 20, 2013. The complaint states:
While working as a dentist at ImmediaDent Urgent Dental Care ("ImmediaDent") clinics, Dr. Jihaad Abdul-Majid, DDS ("Relator) [Licensed to practice dentistry in Indiana and Kentucky. Defendants employed Dr. Abdul-Majid as a dentist from July 2011 to March 2012] discovered that ImmediaDent was operating its dental practices in a manner that perpetrated dental Medicaid fraud against the federal TRICARE program and the Medicaid programs of Indiana, Kentucky, and Ohio ... Dr. Abdul-Majid observed and suspected various types of fraud, including fraudulent billing, excessive and unnecessary treatments of unsuspecting patients, and a sustained pressure by non-dentists in management positions to place corporate profits over patient care by exerting undue influence on dental care decisions. Dr. Abdul-Majid refused to participate in the fraud and tried to stop it or speak out against it internally on numerous occasions. In the end, Dr. Abdul-Majid's anti-fraud efforts caused ImmediaDent to fire him.
Refuse to enter Corporate Integrity Agreement
The companies have refused to enter into a Corporate Integrity Agreement which requires compliance measures and monitoring by OIG. So 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."
According to Valenti's statement to Louisville Business First, the company has "continued to improve its compliance programs, an effort he [Valenti] says predates the complaint." A copy of their compliance plan is available online.
The DOJ press release includes a pretty stern warning to Medicaid providers.
“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.”
Samson Dental Partners and ImmediaDent release