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Texas Pediatric Dental Practices to Pay $8.45M to Settle False Claims Act Charges

Posted  January 10, 2017

By the C|C Whistleblower Lawyer Team

Texas-based MB2 Dental Solutions and 21 of the company’s affiliated pediatric dental practices agreed to pay $8.45 million to resolve allegations they violated the False Claims Act by submitting claims for pediatric dental services that were not rendered, were tainted by kickbacks, or based on misrepresentations of who performed the service. See DOJ Press Release.

According to the government, between 2009 and 2014, MB2 and its affiliated dental practices submitted claims to the Texas Medicaid Fee for Service Program for single-surface fillings in children that were not provided. The government further alleged that MB2 paid kickbacks to Medicaid beneficiaries and their families, marketers and marketing entities in violation of the Anti-Kickback Statute. The government also claimed that MB2 and its dental practices used erroneous Medicaid provider numbers, misrepresenting the dentists performing the pediatric procedures.

As part of the settlement, Dr. Christopher Steven Villanueva, Dr. Trung Minh Tang, Dr. Mauricio Dardano, Dr. Gabriel Shahwan and Dr. Akhil Reddy agreed to pay $250,000 each to resolve the governments’ claims against them individually. They are owners or part owners of MB2 and the dental practices included in the settlement. They also agreed to enter into a five-year Corporate Integrity Agreement which will require an independent review organization to annually assess whether government claims they submit are correctly coded, medically necessary and appropriately documented. In addition, MB2’s head of marketing Frank Villanueva will pay $100,000 to resolve his alleged personal liability.

In announcing the settlement, the government stressed its “unwavering commitment to protect the Medicaid program and the patients it serves from unscrupulous providers.” It further cautioned that it will go after “[p]roviders who waste taxpayer dollars by billing for services that were not provided, or were otherwise improper.” The government pointed to the settlement as a warning to “ensure other dental clinics are aware that we are watching how they operate and will pursue appropriate resolutions when profits are put before patient care.”

Part of the allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former MB2 employee Veronica Garcia. She will receive a whistleblower award of roughly $1.5 million from the proceeds of the government’s recovery.

Tagged in: Anti-Kickback and Stark, Healthcare Fraud, Medicaid, Medical Billing Fraud,