February 27, 2014 — Dental billing fraud is a problem in many states, whether the false claims are made to federal healthcare programs like Medicaid or to private insurance companies. But when dentists make fraudulent claims to Medicaid, the American taxpayers foot the bill. With the assistance of dental care insiders, however, taxpayers have a way to fight back. Under federal and state False Claims Act statutes, whistleblowers are empowered to file a lawsuit on behalf of the government. The qui tam language in the federal Act rewards tipsters with a share of the government’s recovery.
Sacramento Dentist Filed False Claims with Private Insurers
A federal grand jury has found that a Sacramento dentist filed false claims with private insurers for unnecessary work or dental procedures that were never performed. Dr. Davis Lewis first came under investigation in 2012, which probe resulted in the California Dental Board’s closure of the dentist’s practice on Marconi Avenue.
Marconi is alleged to have billed for work on teeth patients didn’t even have and worse, to have done unnecessary work on patients’ healthy teeth just for the opportunity of filing false claims with their insurance carriers.
Investigators with the Dental Board alleged that Lewis focused particularly on UPS employees, paying them to refer their coworkers for dental treatment. UPS seems to have had a particularly generous dental coverage program, with full coverage, no co-pays and no annual limits.
CBS reports that the federal grand jury returned an 18-count indictment against Lewis, whose fraudulent dental billings allegedly totaled over $1 million.
Blowing the Whistle on Dental Medicaid Fraud
Although this California case involved fraudulent claims against private insurers, dental billing fraud often is committed against Medicaid, a federally funded healthcare program. The qui tam lawyers with Waters & Kraus in California, Texas and Maryland are recognized nationally for their aggressive role in whistleblower litigation involving dental Medicaid fraud. We’ve earned our reputation. Contact us by email or phone our dental fraud lawyers at 855.784.0268 to discuss our False Claims Act practice and how we can assist you.
