The agreement resolves allegations that Dr. Malouf and All Smiles -- a 51-office chain in which he previously held a majority stake -- violated the civil False Claims Act and Texas Medicaid Fraud Prevention Act.
Between 2004 and 2007, All Smiles submitted to Medicaid orthodontic-related claims for services that "were not furnished or rendered, were unbundled and/or not properly documented," according to the U.S. Attorney's Office for the Northern District of Texas.
The Texas Medicaid Fraud Control Unit (MFCU) and FBI initiated the case in response to patient complaints, record reviews, and data analyses.
As part of the settlement, All Smiles entered into a five-year corporate integrity agreement with the U.S. Department of Health and Human Services' Office of Inspector General, according to the agency. The corporate integrity agreement requires All Smiles to adhere to certain policies and procedures to ensure compliance with applicable statutes and regulations that govern claims for federal health care funds.
In April 2010, Dr. Malouf settled potential allegations with the Dallas County District Attorney by repaying MFCU more than $46,000 for certain orthodontic claims and agreeing not to submit claims to Texas Medicaid for an 18-month period.
Dr. Malouf did not admit any wrongdoing or liability as part of that agreement or this latest agreement.
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