More than 300 California dentists suspected of Medicaid abuse

May 18, 2015

A federal audit of dental bills covered by Medicaid found that 329 dentists in California engaged in questionable billing practices. [Contra Costa Times]

The U.S. Department of Health and Human Services audit also identified six orthodontists in California with questionable billing records. In all, the 329 dentists and six orthodontists received $118 million for pediatric dental work in 2012, the year auditors examined.

One California dentist billed for more than 1,000 services a day 97 times in 2012. Another dentist billed for 33 procedures, including multiple stainless steel crowns and baby root canals, during a single visit by a 4-year-old patient.

A third dentist received a per-child payment of $699 in 2012. The statewide average was $166 a child.

The federal report, which is due to be released Monday, does not distinguish between dentists who fraudulently bill and those who merely provide services that are not medically necessary. The report states that about 8 percent of California dentists who treat children enrolled in Medicaid may be overbilling.

Federal investigators have not released the names of the dentists suspected of overbilling, but they plan to forward the names to the state. The California Department of Health Care services responded to the report by saying it would step up monitoring of dental care providers and take action if needed.