Grassley's staff has been investigating three private-equity-owned chains -- Kool Smiles, Small Smiles, and ReachOut HealthCare America dental chains serving children on Medicaid.
Pressure from owners who are not licensed dentists have been providing services with the highest Medicaid reimbursement levels, often with inappropriate services, Grassley said. He also expressed concern that children are sometimes receiving unnecessary, often traumatic care, paid for by taxpayers.
A joint investigation by the Center for Public Integrity and PBS' "Frontline" program released last week revealed that the Kool Smiles' business model of serving kids on Medicaid has led to complaints that it overtreats children. Regulators in Georgia and Connecticut have accused the company of overusing expensive stainless steel crowns to treat baby teeth with caries.
Kool Smiles has denied the accusations and provided analysis to show that it doesn’t overbill Medicaid and offers services at a lower cost than other dental providers, according to the story.
The company claims that dentists own the practices, but Grassley said they do not have control, calling them "ghost owners" that allow corporate investors to have control over clinical operations.
The senator is also looking at Aspen Dental Management. Aspen Dental does not accept Medicaid, but Grassley said there are concerns that the company promotes unnecessary treatment plans with expensive credit arrangements.
A CPI/"Frontline" investigation of Aspen found that its business model of serving patients who cannot afford a dentist had led to complaints of overtreatment and loading patients with heavy debt. Aspen Dental denies this and says it offers services to people that other dentists ignore.