For Immediate Release
Media Contact: Bob Cooper
Date: February 4, 2010
Idaho to Receive $92,662 in Medicaid Settlement
(Boise) – The State of Idaho will receive $92,662 from a legal settlement with FORBA Holdings, the management company for Small Smiles Dental Clinics, Attorney General Lawrence Wasden said.
The settlement resolves allegations that FORBA caused claims to be submitted to Idaho Medicaid for reimbursement for dental services provided to low-income children. The services were either medically unnecessary or performed in a manner that failed to meet professionally-recognized standards of care. These services included: performing root canals on baby teeth; placing crowns; administering anesthesia (including nitrous oxide); performing extractions; providing fillings and/or sealants; and inappropriately using behavior management techniques to restrain child patients.
The Attorney General’s Medicaid Fraud Control Unit, the Idaho Department of Health and Welfare, 22 other states and the federal government joined to resolve allegations of Medicaid fraud by FORBA. FORBA will make settlement payments over the next five years. Idaho received the first payment today.
As part of the settlement, FORBA has entered into a five-year corporate integrity agreement with the federal government. The agreement will provide procedures and reviews to avoid and promptly detect similar conduct. Specifically, FORBA must have external reviewers monitor its quality of care and reimbursement. In addition, the chief dental office must develop and implement policies and procedures to ensure that the Small Smiles clinics provide services consistent with professionally-recognized standards of care.
The investigation was initiated by three whistleblower lawsuits filed under the Federal False Claims Act. These actions are pending in the United States District Court of the District of Maryland, the Western District of Virginia, and the District of South Carolina.
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