News Briefs: January 15, 2018

◆ Benevis LLC and more than 130 of its affiliated Kool Smiles dental clinics agreed to pay $23.9 million to settle false claims allegations that they billed Medicaid for medically unnecessary dental services performed on children, the Department of Justice (DOJ) said Jan. 10. Between January 2009 and December 2011, DOJ alleged that Benevis (formerly known as NCDR LLC), which provides business management and administrative services to Kool Smiles clinics, and the clinics themselves, billed Medicaid programs for unnecessary baby root canals, tooth extractions and stainless steel crowns. They allegedly also pursued reimbursement for baby root canals that were never performed. According to DOJ, Kool Smiles clinics allegedly used incentives to get dentists to achieve production goals through a system that rewarded productive dentists and penalized the opposite “with substantial cash bonuses based on the revenue generated by the procedures they performed.” Kool Smiles allegedly disregarded “overutilization complaints from their own dentists. The case was set in motion by five lawsuits filed by whistleblowers, three of whom are former Kool Smiles employees, DOJ says. Visit https://tinyurl.com/y9gqe25v.

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