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Catch of the Week: Dental Clinics to Pay $2.7M for Using Unsterilized Tools on Medicaid Patients

Posted  May 28, 2021

For over five years, Upper Allegheny Health Systems, a health care system operating several dental clinics in New York and Pennsylvania, allegedly performed dental services without sterilizing equipment between patients and falsely billed Medicaid for those services. After a former employee blew the whistle, the United States and the State of New York stepped in to investigate, and the defendant agreed to a $2.7 million False Claims Act settlement.

“Shocking” Conduct Risked Patients’ Safety

New York Attorney General Leticia James called it “shocking that the Upper Allegheny Health System skirted protocols and risked the safety of its patients,” in a press release announcing the settlement.

The dental clinics’ conduct violated both New York state and federal laws and placed patients at unnecessary risk, the AG’s release also said. The U.S. Centers for Disease Control and Prevention, the American Dental Association, and the manufacturer of the dental tools all mandate heat sterilization between patient use.

“Patients visit medical offices to seek treatment, not further endanger their health by coming in contact with unsterilized tools,” AG James said.

Dentist Blew the Whistle on the Dangerous Practices

In July 2013, a dentist and former employee of the defendant reported the practices to the government by filing a False Claims Act complaint. Under the Act’s qui tam provisions, private persons can file lawsuits on the government’s behalf and share in the government’s recovery. Whistleblowers play an essential role in helping the government identify and put a stop to healthcare fraud, particularly where patients are endangered, as in cases like this.

New York AG James acknowledged the whistleblower’s central role in this case, noting that “we may have never known about these disturbing practices had a whistleblower not come forward.”

Expose Healthcare Fraud

If you have information about similar misconduct or another type of fraud in healthcare, you might have a case under the False Claims Act and you may be eligible to receive a whistleblower reward. Contact our whistleblower lawyer team to learn more.

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Tagged in: Catch of the Week, FCA Federal, Government Programs Fraud, Healthcare Fraud, Importance of Whistleblowers, Lack of Medical Necessity, Medicaid, Medical Billing Fraud, Whistleblower Case,