OIG Issues Latest Report Targeting Dental Providers

OIG Issues Latest Report Targeting Dental Providers


The Office of the Inspector General (OIG) has issued its latest report in its state-by-state series examining pediatric dental services provided under Medicaid.  This newest report examines such practices in California, and follows closely on the heels of previous reports examining pediatric dental billings in North Carolina, Indiana, Louisiana, Texas and New York.  As with previous reports, the OIG found what it believes are significant questionable billing practices. 

Key information from the report and what to take away from it include:

This latest drumbeat from the OIG makes it clear that they intend to bring increased scrutiny to Medicaid pediatric dental billings. The OIG has undertaken a robust data-driven review of claims on a statewide basis that is intended to serve as a roadmap for state and federal authorities to investigate these providers. Moreover, as with all the reports in these series, the OIG has focused the majority of its attention on what it terms “dental chains.” As such, pediatric dental providers who bill Medicaid would be well served to closely examine both the report, as well as their own billing patterns and compliance program.  This is doubly true for providers that are part of DSOs and other multi-practice structures. 

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