November 28, 2014 — Dental Medicaid fraud is frequently apparent to dental clinic insiders. But many are reluctant to come forward for fear of losing their jobs — until they are asked to participate. For many, that’s the point at which they seek legal help to thwart billing fraud schemes against Medicaid. When tipsters bring a lawsuit against unethical dental practices under the qui tam language of the False Claims Act, they may be rewarded for their courage with a portion of the government’s recovery.
Former Illinois Dentist Submitted False Claims To Insurance Companies For Services Never Performed
Frank Koe Jr., a former dentist who practiced in Normal, Illinois, has pleaded guilty to defrauding dental insurance companies for a decade. The dentist will be sentenced in February. From 2002 to 2012, the dentist received payment for claims made to dental insurance companies for services that were not as extensive as those described in the filed insurance claims. In some cases, no services were provided at all.
As a result of this dental billing fraud, the Illinois Department of Financial and Professional Regulation has placed the dentist’s license on inactive status. In addition, Koe reportedly was required to pay a $5000 fine.
Conscientious Insiders Collaborate to End Fraudulent Billing Schemes
While the billing fraud in this case involved private insurers rather than Medicaid, Waters & Kraus represents whistleblowers in similar lawsuits that do center on False Claims Act violations involving Medicaid. If you’re an insider with claims against a dental provider concerning Medicaid billing violations, email us or call our qui tam attorneys at 855.784.0268 to learn more about our practice and how we can work together to notify the government about fraudulent abuses of government-funded programs. Charles Siegel and Dan Hargrove, qui tam lawyers in Waters & Kraus’ Texas office, protect tipsters throughout the whistleblower lawsuit process.