NY Medicaid probe finds $40M in dental fraud

New York's Medicaid program paid out $40 million for excessive dental cleanings and exams over five years, according to an audit from the state controller's office.

Among the dubious claims was a dental clinic got paid for 79 exams given to one patient over four years, according to a statement by New York State Comptroller Thomas DiNapoli.

The law allows only eight exams over four years.

Other findings included a dentist who billed for 18 cleanings for one patient over five years and a patient who received 32 cleanings from 19 separate dentists over three years, DiNapoli said.

"New York needs to root out the rot in the Medicaid dental system," DiNapoli said in a statement accompanying the audit.

DiNapoli's audit also found that the state paid higher rates to dentists for cleanings and examinations than many other states, costing taxpayers as much as $60 million.

The audit reviewed $418 million in Medicaid dental transactions during a five-year stretch that ended in August 2009. It did not include the names of the dentists or of the patients who received the excessive treatments.

DiNapoli recommended that the New York State Health Department implement tighter billing controls to root out excessive payments.

The Health Department said it would review DiNapoli's recommendations and seek to recover any excessive payments.

Copyright © 2010 DrBicuspid.com

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