August 20, 2012 — What could be better than having a dentist come to your child’s school and give them a free evaluation? Maybe it’s hard to get to a community dentist, one less thing to take care of on your own and the checkup is free. And how nice and comforting it is when the dentists coming to take care of your child is part of something called Big Smiles mobile dental clinics? That sounds like a group looking out for kids.
But what if the dentists do work on your child that you didn’t know about or didn’t want? What if they did work your child didn’t need? What if you never gave permission for them to see your child at all? And what if multiple adults held down your screaming child to drill his teeth? All of these things have allegedly happened, according to the The Republic.
Mobile Dental Clinics May Be More Interested In Medicaid Billing Than In Patient Care.
The idea of a mobile dental clinic to serve low-income children who may not have regular access to a dentist is a good one. Unfortunately, the reality of such clinics is that they too often are more concerned with maximizing Medicaid billings than they are in taking good care of children’s dental needs. ReachOut Healthcare, which runs the All Smiles mobile dental clinics, was paid $12.5 million by the Arizona Medicaid program in the last two years alone.
Because of the many allegations against Big Smiles and other mobile dental clinics, Arizona and federal regulators are taking a closer look at the companies and their practices. Some school districts have stopped allowing the companies on campus and are instead referring students to community dentists. Some community dentists say that they are already seeing many of these children who receive some treatment at school but need follow-up care, have gotten infections or abscesses, and the mobile dentist has moved on.
Small Smiles and Kool Smiles mobile dental clinics are also the subject of governmental scrutiny because of similar allegations.
Whistleblowers Could Know About Dental Medicaid Fraud Before Regulators.
It is very hard for federal regulators to spot and take action on dental Medicaid fraud in the early stages. There must be a substantial pattern of clearly improper billing or a significant number of patient complaints before the government will be alerted to the problem.
A whistleblower, on the other hand, may have first-hand knowledge about Medicaid dental fraud and be able to alert government regulators before more harm is done. Because their contribution is so important to enforcing the law and stopping Medicaid fraud, the qui tam provisions of the False Claims Act permits a whistleblower to file suit on behalf of the government and to receive a portion of whatever money is recovered.