Texas settles $16M Medicaid fraud case for $39K | Dr. Bicuspid

August 26, 2014 — Texas health officials have accepted a $39,211 settlement from an Austin dental practice that had been charged with improperly billing more than $16 million in orthodontic Medicaid claims.

Glenn Wood, MD, who owns Carousel Pediatrics, disputed fraud allegations made against his clinics by Texas investigators. He claimed that losses of about $400,000 a month in Medicaid payments forced him to shut down his dental affiliate, Trueblood Dental Associates in Austin, and lay off 40 staffers and six dentists. The clinic had served about 28,000 low-income pediatric patients.

Trueblood Dental Associates was originally charged with Medicaid overpayments over a five-year period, from September 2007 to June 2012. In January 2013, Trueblood was placed on a 100% payment hold.

Under the settlement, Trueblood admits no liability for fraud or overpayment, according to a Texas Dentists for Medicaid Reform (TDMR) story. Since Texas has withheld more than $100,000 of Trueblood’s Medicaid monies, the settlement should result in an immediate return payment to the practice, TDMR reported.

Trueblood was formerly the dental affiliate of Carousel Pediatrics, one of Austin’s few Medicaid providers; Carousel settled with the Texas Office of Inspector General (OIG) earlier this year, TDMR said.

Texas has been rocked by allegations of fraud by dentists and orthodontists accused of bilking the state Medicaid program out of tens of millions of dollars. An OIG investigation found $6 billion in fraud and waste within Medicaid from 2004 to 2011.

via Texas settles $16M Medicaid fraud case for $39K .

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