(RALEIGH) Attorney General Josh Stein today announced that he has reached a $375,000 settlement with Santa Maria McKibbins, D.D.S., and her dental practice, Santa McKibbins Family Dentistry, to resolve allegations involving the submission of false claims to the North Carolina Medicaid program. Today’s action is part of the NCDOJ Medicaid Investigation Division’s ongoing Operation Root Canal effort to find and stop fraud among dental providers.
“People who cheat the Medicaid system are cheating taxpayers and people who need health care,” said Attorney General Josh Stein. “My office will continue to fight fraud and abuse among dental providers and other health care providers.”
According to the settlement, Dr. McKibbins and her practice submitted dental claims for restorations allegedly performed on Medicaid recipients between Jan. 1, 2013, and April 30, 2018, that were not medically necessary, had no supporting clinical documentation, and/or were performed in violation of Medicaid policy. Dr. McKibbins has agreed to pay back $375,000 to the Medicaid program.
Operation Root Canal involves a wide variety of dental services, including dental cleanings, use of nitrous oxide, repetitive restorations on the same tooth, palliative care, and upcoding of patient examinations. Through this effort, MID has investigated nine cases of Medicaid fraud among dental providers and won more than $5.75 million in settlements.
This settlement was obtained with the assistance of the North Carolina Department of Justice, Medicaid Investigations Division, and the North Carolina Department of Health and Human Services, Division of Medical Assistance – Clinical Policy and Program Integrity.
About the Medicaid Investigations Division (MID)
The Attorney General’s MID investigates fraud and abuse by healthcare companies and providers, as well as patient abuse and neglect in facilities that are funded by Medicaid. Medicaid is a joint federal-state program that helps provide medical care for people with limited income. To date, the MID has recovered more than $850 million in restitution and penalties for North Carolina.
To report Medicaid fraud in North Carolina, call the North Carolina Medicaid Investigations Division at 919-881-2320.
Laura Brewer (919) 716-6484