September 3, 2012 — Dentist Kristi Ayn Liebau, formerly practicing in Pennsylvania and now living in Texas, has been charged with making false claims against the Medicaid program. Federal investigators first noticed a potential problem when Dr. Liebau billed Medicaid for repairs to six teeth for a single, very young patient. In fact, federal investigators discovered that those particular teeth had not even erupted in the child’s mouth on the day Dr. Liebau claimed to have repaired them.
Dentist Submitted False Claims Against Medicaid for Work Not Performed.
Federal authorities allegedly identified 13 other instances between 2008 and 2011 in which Dr. Liebau billed the Medicaid program for dental treatment that was never actually provided. For example, Dr. Liebau allegedly billed Medicaid for crowns, root canals, and pulpotomies on teeth that were missing or otherwise could not have received the treatment. Court documents provided a number of specific examples:
- In December 2008, Dr. Liebau claimed to perform a four-surface composite restoration on tooth 5, with a root canal and a crown. In fact, tooth 5 was extracted.
- In July 2009, Dr. Liebau billed Medicaid for performing a total of 20 composites on every primary tooth in the mouth of a 3-year-old patient. This work was purportedly performed in a single 19-minute surgical procedure.
- In August 2009, Dr. Liebau billed Medicaid for pulling two primary teeth that were still present after the purported extractions.
Through her attorney, Dr. Liebau has indicated that she has negotiated a plea deal with federal prosecutors. The plea hearing has been set for September 20, 2012, according to the Erie Times-News.
Whistleblowers Can Help Identify and Stop Dental Medicaid Fraud.
Whistleblowers can be a partner for federal authorities in identifying and stopping dental Medicaid fraud. By coming forward with information about fraud against the government, the whistleblower can focus the attention of federal investigators and provide evidence of fraud.
Because the assistance of whistleblowers is so important in fighting dental Medicaid fraud, the qui tam provisions of the False Claims Act allow a whistleblower to file a private lawsuit on behalf of the government and to share with the government in any recovery.