A large managed dental care plan has agreed to pay $4.5 million to settle claims that it improperly billed Oregon’s Medicaid plan for calls to patients about oral hygiene counseling but offered no real advice, according to the Oregon Department of Justice.
Advantage Dental Plan Services, a DentaQuest company, allegedly made thousands of nutrition and dental counseling calls to patients to pad its numbers to meet requirements for certain Medicaid payments. In addition to not offering real counseling to patients, Advantage reportedly didn’t have consent from patients, according to a press release dated October 2 from the Oregon Department of Justice.
Advantage Dental will pay $2.25 million in restitution and $2.25 million in penalties. Despite the settlement, Advantage denies the allegations, according to the press release.
Between January 2020 and December 2025, Advantage Dental allegedly billed for phone calls it recorded as "nutrition and oral hygiene counseling," even though the calls didn’t include real dental advice or have the patient’s consent. The dental care plan purportedly used these claims to hit performance and quality targets in its contracts, which earned it yearly incentive payments that are funded by Medicaid, according to the press release.
Without these improper billing claims, Advantage Dental, which services more than 465,000 members in Oregon, would not have received much of those incentives, according to the press release.
“The Oregon Health Plan is funded by taxpayer dollars, and Oregonians expect that those funds will pay for health care -- not bogus gimmicks that don’t offer any actual care,” Oregon Attorney General Dan Rayfield said in the press release. “Advantage Dental put profits ahead of patients. If you bill the Oregon Health Plan, you need to deliver real care, and we’ll keep holding providers accountable when they don’t.”
