Sometimes dentists or dental assistants find themselves employed in a practice that they know is engaging in fraud. They may know about unnecessary procedures that are being done or be aware that Medicaid is being billed for procedures that aren’t performed. In some cases, dentists have found themselves being pressured to engage in dental Medicaid fraud themselves.
Dental Medicaid fraud is against the law. Filing a claim with Medicaid for dental procedures that are medically unnecessary or that have not been performed is a violation of the federal False Claims Act. Many states also have false claims acts as well, so that perpetrators may face state as well as federal charges for engaging in dental Medicaid fraud.
If you know about an instance of dental Medicaid fraud, you may feel unsure of what to do next. It may help to have someone to talk to about your circumstances and your legal rights – someone who has worked with whistleblowers confronting situations like yours.