FORNEY, Texas — A Forney dental office is among 21 affiliated dental practices who have agreed to pay $8.45 million to resolve allegations of false Medicaid claims for pediatric dental services, U.S. Attorney John Parker of the Northern District of Texas announced Monday.
FORNEY, Texas — A Forney dental office is among 21 affiliated dental practices who have agreed to pay $8.45 million to resolve allegations of false Medicaid claims for pediatric dental services, U.S. Attorney John Parker of the Northern District of Texas announced Monday.
The allegations, according to Parker, stem from incidents between Jan. 1, 2009, and Dec. 31, 2014 in which Texas-based MB2 Dental Solutions (MB2), 21 pediatric dental practices affiliated with MB2, and their owners and marketing chief knowingly submitted, or caused the submission of, claims for pediatric dental services that were not rendered, were tainted by kickbacks, or falsely identified the person who performed the service.
“The settlement also resolves allegations that MB2 paid kickbacks to Medicaid beneficiaries and their families, marketers, and marketing entities, in violation of the Anti-Kickback Statute, and that MB2 and affiliated dental practices used erroneous Medicaid provider numbers misrepresenting the dentists performing the pediatric procedures,” stated a press release from the U.S. Attorney’s Office for the Northern District of Texas.
MB2 is a Carrollton, Texas-based dental management firm which provides management services to affiliated dental offices including Dental Family Circle PLLC which is doing business as Forney Wellness Dental in Forney, Texas — which is included in the settlement.
“As part of the settlement agreement today, Drs. Christopher Steven Villanueva, Trung Minh Tang, Mauricio Dardano, Gabriel Shahwan and Akhil Reddy agreed to pay $250,000 each to resolve the governments’ claims against them individually,” states the release “They are owners or part owners of MB2 and the dental practices included in this settlement, and practice dentistry in Texas.”
Additionally, Drs. Villanueva, Tang, Dardano, Shahwan, and Reddy have entered into a five-year Corporate Integrity Agreement (CIA) with the Department of Health and Human Services Office of Inspector General (HHS-OIG) which allows for an annual assessment of the doctors claims and if they were correctly coded, medically necessary, and appropriately documented.
MB2’s head of marketing, Frank Villanueva, was also ordered to pay $100,000 to resolve his alleged personal liability. Frank Villanueva also served in a marketing capacity for HalfTime Pizza & Burgers which operated in Forney from June 2012 until May 2013.
"As the new owner of Forney Wellness Dental, I purchased at the end of 2014, I can tell you we have cooperated with everything they have asked for and new policies were put in place when I took over," read a statement from Forney Wellness on Monday evening. "We have transformed this office into a great family friendly office and look forward to serving the community for years to come!"
“Today's settlement demonstrates our unwavering commitment to protect the Medicaid program and the patients it serves from unscrupulous providers,” stated Parker. “Providers who waste taxpayer dollars by billing for services that were not provided, or were otherwise improper, will be held accountable.”
The other dental practices included in the settlement are Dental Professionals of Texas PLLC; Archstone Dental PLLC; Bliss Dental PLLC; Crescent Dental PLLC; Dental Central PLLC; DFW Family Dental Centers PLLC; Element Dental PLLC; Fresh Dental PLLC; Galaxy Dental PLLC; Legend Dental PLLC; Peppermint Dental PLLC; Picasso Dental PLLC; Sage Dental PLLC; Spearmint Dental PLLC; Tide Dental PLLC; Vida Dental PLLC; Viva Orthodontics PLLC and Wow Dental PLLC.
“Part of the allegations resolved by this settlement were originally filed under the qui tam, or whistleblower, provisions of the False Claims Act by Veronica Garcia, a former MB2 employee,” states the release. “The act permits private parties to sue on behalf of the government for false claims for government funds and to receive a share of any recovery. It also permits the government to intervene in such lawsuits, as it did in this case. Ms. Garcia will receive $1.521 million from the United States and the State of Texas.”
“This settlement illustrates the government’s emphasis on combating health care fraud and marks another achievement for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, which was announced in May 2009 by the Attorney General and the Secretary of Health and Human Services,” states the release. “The partnership between the two departments has focused efforts to reduce and prevent Medicare and Medicaid financial fraud through enhanced cooperation. One of the most powerful tools in this effort is the False Claims Act. Since January 2009, the Justice Department has recovered a total of more than $31.8 billion through False Claims Act cases, with more than $19.3 billion of that amount recovered in cases involving fraud against federal health care programs.”
“HHS-OIG is particularly vigilant about potential abuses in Medicaid pediatric dental offices where patients and their families are especially vulnerable to questionable practices,” said Special Agent in Charge CJ Porter for the HHS-OIG in Dallas. “Today’s settlement should 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.”