More than 300 California dentists suspected of Medicaid abuse

May 18, 2015

baby-money1_0A 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.



  1. r0y says:

    Only 329 in all of California?! Only $118 million scammed? In the WHOLE STATE!?

    Either they don’t look really hard and careful, or we totally have some honest dentists! I’ve read that 1 out of 5 licensed dentists is in California and there were approx. 190,000 licensed dentists in 2012; that would mean at least 38,000 dentists licensed in California.

    They found 329 “bad” ones? Out of 40K? That’s like 0.87% fraud rate. WOW! Great news, indeed!

    (-1) 1 Total Votes - 0 up - 1 down
  2. achillesheal says:

    Not surprised. All government programs are wrought with fraud. Yet government wants more and more from the taxpayer to administer their broken programs.

    They cut reimbursement rates for these programs so decent dentists decide they will no longer accept medicaid and the unscrupulous bill 500 times for the same procedure.

    We need more big government! It works so well.

    (11) 17 Total Votes - 14 up - 3 down
    • OnTheOtherHand says:

      I don’t know if the reimbursement rates for dentists are that bad but I do know that is a factor in the treatment people get from many doctors when either Medicare or an HMO is involved.

      (0) 4 Total Votes - 2 up - 2 down
  3. smiley says:

    They should be shot in the back of the head! Not happy with being a dentist and making the living that goes with the profession, they have to rob the rest of us.

    (3) 11 Total Votes - 7 up - 4 down
  4. euroamerican says:

    Yeah, when Obama care hit the market my private insurance went up by $250 a month for Pediatric Dentistry…

    (14) 18 Total Votes - 16 up - 2 down
  5. TaxMeAgain says:

    If found in fault, each name should be released.

    (16) 18 Total Votes - 17 up - 1 down
  6. Rich in MB says:

    Of course the Dentists are no better than the welfare queen.
    Folks when there is a big pile of Government money, the pigs belly up to the trough.
    Yet…some still live in a fantasy world where Government is the solution and not the problem.

    (15) 49 Total Votes - 32 up - 17 down
    • OnTheOtherHand says:

      I’m curious Rich, what is your solution to problems like this? No medicare coverage at all? Just let the elderly who lack the financial resources to pay for medical services suffer?

      I agree that the government, especially the feds, often badly mismanages their programs but, unless you are entirely sociopathic and don’t care about anyone else, suggest a practical alternative.

      My suggestions would be to stop allowing lobbyists to be involved in setting up such programs (although I don’t know how to do that easily) and to make sure that those overseeing the programs have the moral integrity, competence and funding to do so (almost equally difficult.)

      (-1) 7 Total Votes - 3 up - 4 down
      • Rich in MB says:

        Moral integrity and Government….ha ha ha
        You are exposing your fatal flaw sir, those two don’t exist together.
        Thus the solution is NOT in Government and your reluctance to admit what is so clearly in front of your face is your liberal flaw. Truth, facts, reality…they all disprove the liberal utopia…but your belief, even faith in Government keeps you from realizing the truth even as it smacks you upside the head.

        (1) 5 Total Votes - 3 up - 2 down
      • achillesheal says:

        This is medicaid fraud not medicare fraud. Medicaid is welfare administered by the states.

        (1) 1 Total Votes - 1 up - 0 down

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