A dental management company with multiple Texas clinics has been fined nearly $24 million for submitting false claims to state Medicaid programs - including Texas' - and performing unnecessary dental work on children.
The fine against Benevis LLC - as well as its affiliated Kool Smiles clinics - was announced Thursday by the U.S. Justice Department.
DOJ lawyers said in a press release that between 2009 and 2011, Benevis, through its more than 130 Kool Smiles clinics in 17 states, submitted false claims for medically unnecessary treatments, including baby root canals, tooth extractions and stainless steel crowns.
DOJ also said Kool Smiles knowingly submitted false claims to the Texas Medicaid Program for First Dental Home, which is aimed at providing dental services to children under 3 years old.
The chain had years ago come under fire in Texas after it was reported that it was paying bonuses to dentists to hit production targets.
"Today's settlement sends a very clear signal: Fraud in the federal healthcare system will not be tolerated, "U.S. Attorney for the Western District of Texas John F. Bash said in a statement. "Especially when that fraud involves performing unnecessary procedures on kids—here, unnecessary baby root canals and tooth extractions, among other procedures—we will not hesitate to use every tool at our disposal to punish those who break the law."
DOJ's investigation was sparked by five lawsuits filed under the whistleblower provision of the False Claims Act, through which private citizens can file suit on behalf of the United States for false claims and share in a portion of any funds recovered. Three former Kool Smiles employees will receive payments totaling more than $2.4 million, DOJ said.
Texas will receive a share of the roughly $10 million recovered in false state Medicaid claims.