Two dental companies agree to $5.1 million settlement for alleged fraud
November 13, 2018
Indianapolis — A whistleblower dentist aided the federal and Indiana state government in securing a $5.1 million settlement from two dental firms after the companies allegedly engaged in various types of Medicaid fraud, as well as other transgressions, from 2009-13.
Samson Dental Partners and ImmediaDent were alleged to have engaged in fraudulent billing and excessive and unnecessary treatment. The two companies were allegedly “prioritizing corporate profits over patient care,” with nondentists in management positions exerting influence on dental care decisions, according to the settlement agreement.
The whistle-blowing dentist, Dr. Jihaad Abdul-Majid, received $925,000, plus expenses, lawyer fees and other costs. He was an employee of ImmediaDent but left in 2012.
ImmediaDent operates nine dental practices in Indiana, with Samson (headquartered in Leawood, Kansas) delivering administrative and other support services to ImmediaDent. ImmediaDent provided services that were reimbursed by the Medicaid program.
“Working to recover taxpayer funds taken through fraud and other illegal means is part of our responsibility as stewards of the public trust,” Indiana Attorney General Curtis Hill said in a statement. “We appreciate the collaboration of our federal partners in this particular case, and we intend to remain vigilant going forward to make sure Medicaid monies are used for their designated purposes.”
“Let this be a warning to health care organizations that the United States government is watching, and will continue to watch for false claims no matter how large or small,” U.S. Attorney Russell M. Coleman said in a statement. “The United States Attorney’s office is protecting the taxpayers’ dollars every day with the help of our state and local partners.”
The federal government and the state of Indiana alleged that they had certain civil claims against Samson and ImmediaDent arising from the submission of false claims for payment to Medicaid for the following conduct, according to a news release issued by James R. Moriarty, one of Dr. Abdul-Majid’s attorneys:
- Samson engaged in the corporate practice of dentistry in violation of Indiana state law by exerting obtrusive influences over ImmediaDent's medical professionals and staff by rewarding production and disciplining for not meeting production objectives and directing personnel in a manner which compromised clinical judgment.
- Samson and ImmediaDent upcoded simple tooth extractions and improperly billed them as surgical extractions.
- Samson Dental Partners, LLC and ImmediaDent improperly billed for scaling and root planing when they were either not performed or not medically necessary.
Samson and ImmediaDent released a statement about the suit: “There are several important facts about this resolution: First, it is important to note that none of the allegations in the case suggested that any patient was harmed or mistreated, or that substandard care was provided. Rather, the matter relates to coding and billing issues for certain procedures. Second, the claims involve services provided five to 10 years ago and began under prior management. Third, even before being contacted by the government about this matter, Samson identified an opportunity to enhance its performance in these areas and began implementing compliance program improvements.
“The settlement agreement that Samson and ImmediaDent have entered into is not a concession of any wrongdoing by Samson Dental Partners or ImmediaDent, their employees or dentists. To the contrary, the companies strongly disagree with the assertion that they knowingly did anything improper. However, after almost four years of litigation and significant expense already incurred, the companies have concluded that their collective energies are better focused on continuing their expansion efforts, and working to provide the best care possible to patients.”
The settlement agreement is available at http://media.ibj.com/Lawyer/websites/opinions/index.php?pdf=2018/october/DentalSettlementAgreement.pdf