The recent charges brought against a dental center in Anderson, Indiana for Medicaid fraud demonstrate how easy it is for healthcare professionals to abuse the taxpayer-funded system to their own advantage. In this case, the internal checks and balances set up to detect this kind of fraud were effective.
The Indiana Medicaid Fraud Control Unit (MFCU) began their investigation when they noted a striking discrepancy. The Anderson Dental Center billed for deep sedation procedures more often than any other dentist office — even though they had no licensed anesthesiologist on their staff. In fact, patients were routinely given local anesthesia, but Medicaid does not reimburse for this service. Between 2006 and 2011, the center received $300,000 from Medicaid for deep sedation services they never provided.
The center allegedly padded their Medicaid claims in other ways, in addition to a number of other illegal actions:
The office of the Attorney General issued felony indictments against the three dentists who owned the center, as well as five of their employees. Everyone appears to have been in on the game.
Indiana encourages citizens to be aware of Medicaid fraud and report any instances that they notice. If you have evidence of fraud, you may be able to initiate a lawsuit against the wrongdoer and collect a portion of the judgment under the current whistleblower law. Speak to a qualified Indiana Medicaid fraud attorney about your options if you suspect that a healthcare provider or nursing home is engaging in illegal billing practices.