Three dental practices in Southwest Washington reached settlements totaling more than $1 million to resolve allegations that they engaged in fraudulent billing practices that overcharged the Medicaid program.
“Accuracy and honesty from healthcare providers are fundamental to the integrity of the Medicaid system and our ability to help people get the care they need,” Attorney General Nick Brown said. “These settlements are one piece of our many efforts to safeguard the Medicaid program from fraud and abuse.”
The following dental practices reached settlements with the Washington Attorney General’s Office Medicaid Fraud and Abuse Division (MFA) following investigations that found they had submitted unjustified charges to Medicaid:
- Toothdocs, a dental practice in Camas, agreed to a $500,000 civil settlement to resolve claims that 100% of the provider’s billings for so-called parenteral…
Insurance fraud involves making false or exaggerated claims to an insurance provider.
- Hard Fraud: Someone deliberately causes a loss (e.g., setting fire to a warehouse or staging a car accident) specifically to collect a payout.
- Soft Fraud: More common and often viewed as “victimless” by the perpetrator. It involves exaggerating a legitimate claim, such as overstating the value of stolen items in a home burglary to cover the deductible.