In my time as a media professional in the dental industry, I have read a lot of dentist-authored articles about the difficulties of participating in government-managed programs such as Medicaid and CHIP. It’s clear that is a frustrating experience for dentists, who frequently cite abysmal reimbursement rates, huge administrative burdens, and other access-to-care challenges unique to this patient base.
These programs have limited budgets to serve their members, making the issue of fraud, waste, and abuse (FWA) even more of a priority. The Government Accountability Office, for example, found that approximately $36 billion dollars were made in improper reimbursements to Medicaid providers and suppliers. Dentistry has had its own scandals in addition to the conviction of individual providers—earlier this year, Benevis, a prominent DSO, settled Medicaid fraud accusations for $24 million dollars.