Feds raid dental practice over bad Medicaid billing

State and federal agents shut down a county-operated dental clinic in San Rafael, CA, on December 7 during an apparent investigation into its Medi-Cal billing practices, according to an article in the Marin Independent Journal.

The improper billing of the state's public health insurance program took place over three years and reportedly involves nearly $500,000, all of which has been returned, according to a Marin County senior health official.

State agents with the Bureau of Medi-Cal Fraud and Elder Abuse and an agent with the U.S. Department of Health and Human Services entered Marin County Dental Services, which offers care to low-income families, during an unannounced visit. Employees were escorted from the building while agents examined records and gathered evidence.

The county health official said that the state had been charged for treatment delivered by dentists who had yet to go through Medi-Cal's approval process. Medi-Cal was not billed for undelivered services. According to the health official, a lack of understanding of Medi-Cal's processes was to blame at the busy practice, which has a budget of $2.3 million and handles 20,000 visits annually. A regularly changing roster of part- and full-time dentists was also cited as a factor.

A new director has been instated at the practice, which now bills Medi-Cal through the nonprofit Marin Community Clinic.

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