John­son County den­tal busi­ness to pay $5 mil­lion in Med­ic­aid fraud case

The Kansas City Star - - Business - BY ANDY MARSO amarso@kc­star.com

A den­tal busi­ness in Lea­wood has been deemed “a con­tin­u­ing high risk to the fed­eral health care pro­grams and their ben­e­fi­cia­ries,” af­ter agree­ing to pay more than $5 mil­lion to set­tle al­le­ga­tions of Med­ic­aid fraud.

Sam­son Den­tal Part­ners does ac­count­ing, billing and other ad­min­is­tra­tive ser­vices for dozens of Im­me­di­aDent ur­gent care den­tal clin­ics in In­di­ana, Ohio and Ken­tucky. The com­pany and those clin­ics agreed to the set­tle­ment af­ter a whistle­blower al­leged that they sub­mit­ted false Med­ic­aid claims and pres­sured den­tists to pro­vide un­nec­es­sary deep clean­ings to bill more.

“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,” said U.S. At­tor­ney Russell M. Coleman of Ken­tucky. “The U.S. At­tor­ney’s of­fice is pro­tect­ing the tax­pay­ers’ dol­lars ev­ery day with the help of our state and lo­cal part­ners.”

The whistle­blower com­plaint was filed by In­di­ana den­tist Ji­haad Ab­dulMa­jid, who will re­ceive $925,000 of the set­tle­ment.

The com­plaint said Sam­son Den­tal’s non­med­i­cal staff in Lea­wood ex­erted un­due in­flu­ence on the med­i­cal de­ci­sions in the ur­gent care clin­ics by re­ward­ing or dis­ci­plin­ing doc­tors based on how much they were billing.

The of­fice is in Mis­sion Farms, off Mis­sion Road.

Sam­son Den­tal Part­ners, in a state­ment re­leased by vice pres­i­dent of mar­ket­ing Stephen Valenti, em­pha­sized that the set­tle­ment was not an ad­mis­sion of wrong­do­ing.

“To the con­trary, the com­pa­nies strongly dis­agree with the as­ser­tion that they know­ingly did any­thing im­proper,” the state­ment said. “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 state­ment also said that the billing fraud was al­leged to have be­gun in 2009 “un­der prior man­age­ment” and was over by 2013. It said the com­pany had started new pro­ce­dures to en­sure bet­ter Med­ic­aid com­pli­ance even be­fore the whistle­blower com­plaint.

“These ef­forts have con­tin­ued, to­day the com­pa­nies cur­rently main­tain a state-of-the-art com­pli­ance pro­gram which op­er­ates at the fore­front of the ever-chang­ing land­scape of gov­ern­ment-funded pro­grams,” the state­ment said.

Valenti did not ad­dress why Sam­son Den­tal de­clined to par­tic­i­pate in a Cor­po­rate In­tegrity Agree­ment with the U.S. De­part­ment of Health and Hu­man Ser­vices’ Of­fice of In­spec­tor Gen­eral. The of­fice, known as OIG, had asked to reg­u­larly mon­i­tor Sam­son Den­tal and Im­me­di­aDent’s Med­ic­aid com­pli­ance as part of the set­tle­ment.

“The com­pa­nies re­fused to agree to this over­sight,” a state­ment from the U.S. De­part­ment of Jus­tice said. “OIG has de­ter­mined that in the ab­sence of such over­sight, the com­pa­nies pose a con­tin­u­ing high risk to the fed­eral health care pro­grams and their ben­e­fi­cia­ries.”

In­di­ana At­tor­ney Gen­eral Cur­tis Hill said state and fed­eral law en­force­ment would keep an eye on the com­pa­nies, and other health care providers.

“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,” Hill said in a state­ment re­leased by the Jus­tice De­part­ment.

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