Rutledge Part of $24 Million Kool Smiles Settlement
February 2, 2018
Arkansas to receive over $475,000
LITTLE ROCK – Arkansas Attorney General Leslie Rutledge has joined with the United States, the District of Columbia and 19 other states to reach a settlement with Benevis LLC and 133 Kool Smiles Clinics, resolving allegations that the company submitted false claims to the Medicaid program by performing unnecessary procedures. This included providing stainless steel crowns, performing tooth extractions and baby pulpotomies on pediatric patients and failing to offer less costly treatment options when available.
Benevis and Kool Smiles will pay the federal government $23.9 million. Arkansas will receive $478,500 in restitution and other recoveries.
“The State of Arkansas will not tolerate irresponsible actions by companies that not only cost patients more of their hard-earned money, but also increase cost to taxpayers across the country,” said Attorney General Rutledge. “Patients rely on and trust medical professionals, including dentists, to provide the best and most cost effective care possible.”
The settlement also resolves allegations that Benevis and Kool Smiles failed to implement appropriate audit processes and engaged in conduct resulting in overutilization of procedures. Such allegations were productivity bonuses based on revenue generated by performed procedures, scheduling practices that maximized patient visits per day and pressure to meet production goals, including termination of dentists failing to meet productivity goals from January 1, 2009 through December 31, 2011.
Benevis LLC, formerly known as NCDR, LLC, is a private company that provides non-clinical practice support services to dentists and dental clinics, including services relating to the management of clinic finances and administration. Since approximately 2002, Benevis has provided support to Kool Smiles Dental Clinics located throughout the United States, including the 133 Kool Smiles Clinics at issue in the agreement. The clinics are owned by professional corporations that are owned by licensed dentists and provide dental care to children and some adults, including beneficiaries covered by Medicaid.
A National Association of Medicaid Fraud Control Units (NAMFCU) team investigated the allegations in conjunction with the Department of Justice and United States Attorneys Offices in Connecticut, the Southern District of Texas, the Western District of Texas and the Eastern District of Virginia. The NAMFCU team included representatives from the Offices of the Attorneys General for the states of Texas, Massachusetts, South Carolina, New York and Virginia.