Kool Smiles to Pay $23.9M for Allegedly Performing Unnecessary Medical Services on Kids

The parent company of Kool Smiles dental clinics will pay $23.9 million, plus interest, for allegedly performing medically unnecessary dental services on children insured by Medicaid.

Kool Smiles has two locations in Lubbock: 1923 Marsha Sharp Freeway and 2903 50th St.

The Justice Department said in a news release Wednesday that Benevis LLC, which owns Kool Smiles, “knowingly submitted false claims to state Medicaid programs for medically unnecessary pulpotomies (baby root canals), tooth extractions, and stainless steel crowns, in addition to seeking payment for pulpotomies that were never performed.”

The unnecessary procedures allegedly took place between January 2009 and December 2011, according to the news release.

"Kool Smiles clinics routinely pressured and incentivized dentists to meet production goals through a system that disciplined 'unproductive' dentists and awarded 'productive' dentists with substantial cash bonuses based on the revenue generated by the procedures they performed,” according to the news release.

Three former employees will receive more than $2.4 million for being whistleblowers.

“When providers accept federal funds for reimbursement, they have a duty and responsibility to provide the best care possible to the patient, especially when their patients are economically disadvantaged children,”  U.S. Attorney Ryan K. Patrick for the Southern District of Texas said in the release. “The United States Attorney’s Office for the Southern District of Texas will aggressively prosecute healthcare providers who fail to provide care as required when it adversely affects the taxpayers.”

Read more on the settlement here.

(Information from BigCountryHomepage.com)

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