Dental Care Company to Pay $23.9M in Whistleblower Settlement
Benevis dental management company and more than 130 of its affiliated Kool Smiles clinics in 17 states have agreed to pay $23.9 million plus interest to settle charges that they fraudulently billed Medicaid for medically unnecessary dental work performed on children.
January 12, 2018 at 03:39 PM
3 minute read
![Department-of-Justice](https://images.law.com/contrib/content/uploads/sites/390/2018/01/011218Department-of-Justice.jpg)
A dental management company and more than 130 of its affiliates in 17 states have agreed to pay $23.9 million plus interest to settle civil charges that they fraudulently billed the government for medically unnecessary dental services performed on children, the U.S. Department of Justice announced.
“The allegations in these cases are particularly egregious because they involved medically unnecessary dental services performed on children,” said John H. Durham, U.S. attorney for the District of Connecticut in a statement.
Kool Smiles dental clinics and their parent company, Benevis, formerly known as NCDR, based in Marietta, Georgia, violated the federal False Claims Act by billing state Medicaid programs for medically unnecessary baby root canals, tooth extractions and stainless steel crowns, as well as baby root canals that were never performed, according to the Justice Department.
During the scheme from January 2009 to December 2011, the Kool Smiles clinics also routinely pressured and incentivized dentists to meet production goals through a system that disciplined “unproductive” dentists and rewarded “productive” dentists with substantial cash bonuses based on the revenue generated by the procedures they performed, the DOJ said. The clinics ignored complaints about the practice from their own dentists, the agency added.
The claims resolved by the settlement were allegations only, and there was no determination of liability, according to the Justice Department.
A spokeswoman for Benevis, did not immediately respond to an emailed request for comment on Friday afternoon.
Three whistleblowers who filed the False Claims Act lawsuits—former Kool Smiles employees Adam Abendano, Poonam Rai and Robin Fitzgerald—will receive a combined $2.4 million for their share of the recovery. Of the nearly $24 million payment, about $14.2 million will go to the federal government and about $9.7 million to the states, according to the DOJ statement.
Five lawsuits filed under the whistleblower provision of the False Claims Act started the investigation. Four cases are pending in the District of Connecticut and one is pending in the Western District of Texas, according to the news release.
Special Agent-in-Charge Phillip Coyne of the U.S. Department of Health and Human Services Office of Inspector General said: “It is intolerable when health care companies seek to boost profits by defrauding Medicaid and exploiting children.”
“Systematically performing and billing for medically unnecessary dental procedures undermines the well-being of these young patients, corrupts the impartiality of medical decision-making, and diverts money from taxpayer-funded health care programs designed to pay for legitimate medical needs.”
In Connecticut, the investigation was handled by Assistant U.S. Attorney Richard M. Molot.
The cases are: United States, et al., ex rel. Abendano v. NCDR, et al., 3:10-cv-1100 (JBA) (D. Conn.); United States, et al., ex rel. Greenwald v. Kool Smiles Dentistry, 3:10-cv-1100 (JBA) (D. Conn.); United States, et al., ex rel. Rai, et al. v. Kool Smiles Dentistry, 3:17-cv-834 (JBA) (D. Conn.); United States, et al., ex rel. Bowne v. KS-VAP, 3:16-cv-369 (JBA) (D. Conn.); and United States, et al., ex rel. Alves, et al. v. NCDR, SA-13-CV-0760H (W.D. Tex.).
This content has been archived. It is available through our partners, LexisNexis® and Bloomberg Law.
To view this content, please continue to their sites.
Not a Lexis Subscriber?
Subscribe Now
Not a Bloomberg Law Subscriber?
Subscribe Now
NOT FOR REPRINT
© 2025 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.
You Might Like
View All![Trump Taps McKinsey CLO Pierre Gentin for Commerce Department GC Trump Taps McKinsey CLO Pierre Gentin for Commerce Department GC](https://images.law.com/cdn-cgi/image/format=auto,fit=contain/https://k2-prod-alm.s3.us-east-1.amazonaws.com/brightspot/6a/c0/2a90c5cb477389be51e3152e80f4/pierre-gentin-767x633-1.jpg)
Trump Taps McKinsey CLO Pierre Gentin for Commerce Department GC
![GOP Now Holds FTC Gavel, but Dems Signal They'll Be a Rowdy Minority GOP Now Holds FTC Gavel, but Dems Signal They'll Be a Rowdy Minority](https://images.law.com/cdn-cgi/image/format=auto,fit=contain/https://k2-prod-alm.s3.us-east-1.amazonaws.com/brightspot/4e/5a/5ad53ca64ad18684ad71233d78fb/alvaro-bedoya-767x633.jpg)
GOP Now Holds FTC Gavel, but Dems Signal They'll Be a Rowdy Minority
6 minute read![New FCC Chair Hires Section 230 Critic as General Counsel New FCC Chair Hires Section 230 Critic as General Counsel](https://images.law.com/cdn-cgi/image/format=auto,fit=contain/https://k2-prod-alm.s3.us-east-1.amazonaws.com/brightspot/b9/d8/54d7475743b5b95da8386e800eac/adam-candeub-767x633-1.jpg)
![Fired by Trump, EEOC's First Blind GC Lands at Nonprofit Targeting Abuses of Power Fired by Trump, EEOC's First Blind GC Lands at Nonprofit Targeting Abuses of Power](https://images.law.com/cdn-cgi/image/format=auto,fit=contain/https://images.law.com/corpcounsel/contrib/content/uploads/sites/390/2023/10/Karla-Gilbride-767x633.jpg)
Fired by Trump, EEOC's First Blind GC Lands at Nonprofit Targeting Abuses of Power
3 minute readTrending Stories
- 1With AI, What Changes Can Midsize Firms Expect?
- 2Saul Ewing Loses Two Partners to Fox Rothschild, Marking Four Fla. Partner Exits in Last 13 Months
- 3Eagles or Chiefs? At These Law Firms, Super Bowl Sunday Gets Complicated
- 4Former NY City Hall Official Tied to Adams Corruption Probe to Plead Guilty
- 5Wilmer, White & Case, Crowell Among the Latest to Add DC Lateral Partners
Who Got The Work
J. Brugh Lower of Gibbons has entered an appearance for industrial equipment supplier Devco Corporation in a pending trademark infringement lawsuit. The suit, accusing the defendant of selling knock-off Graco products, was filed Dec. 18 in New Jersey District Court by Rivkin Radler on behalf of Graco Inc. and Graco Minnesota. The case, assigned to U.S. District Judge Zahid N. Quraishi, is 3:24-cv-11294, Graco Inc. et al v. Devco Corporation.
Who Got The Work
Rebecca Maller-Stein and Kent A. Yalowitz of Arnold & Porter Kaye Scholer have entered their appearances for Hanaco Venture Capital and its executives, Lior Prosor and David Frankel, in a pending securities lawsuit. The action, filed on Dec. 24 in New York Southern District Court by Zell, Aron & Co. on behalf of Goldeneye Advisors, accuses the defendants of negligently and fraudulently managing the plaintiff's $1 million investment. The case, assigned to U.S. District Judge Vernon S. Broderick, is 1:24-cv-09918, Goldeneye Advisors, LLC v. Hanaco Venture Capital, Ltd. et al.
Who Got The Work
Attorneys from A&O Shearman has stepped in as defense counsel for Toronto-Dominion Bank and other defendants in a pending securities class action. The suit, filed Dec. 11 in New York Southern District Court by Bleichmar Fonti & Auld, accuses the defendants of concealing the bank's 'pervasive' deficiencies in regards to its compliance with the Bank Secrecy Act and the quality of its anti-money laundering controls. The case, assigned to U.S. District Judge Arun Subramanian, is 1:24-cv-09445, Gonzalez v. The Toronto-Dominion Bank et al.
Who Got The Work
Crown Castle International, a Pennsylvania company providing shared communications infrastructure, has turned to Luke D. Wolf of Gordon Rees Scully Mansukhani to fend off a pending breach-of-contract lawsuit. The court action, filed Nov. 25 in Michigan Eastern District Court by Hooper Hathaway PC on behalf of The Town Residences LLC, accuses Crown Castle of failing to transfer approximately $30,000 in utility payments from T-Mobile in breach of a roof-top lease and assignment agreement. The case, assigned to U.S. District Judge Susan K. Declercq, is 2:24-cv-13131, The Town Residences LLC v. T-Mobile US, Inc. et al.
Who Got The Work
Wilfred P. Coronato and Daniel M. Schwartz of McCarter & English have stepped in as defense counsel to Electrolux Home Products Inc. in a pending product liability lawsuit. The court action, filed Nov. 26 in New York Eastern District Court by Poulos Lopiccolo PC and Nagel Rice LLP on behalf of David Stern, alleges that the defendant's refrigerators’ drawers and shelving repeatedly break and fall apart within months after purchase. The case, assigned to U.S. District Judge Joan M. Azrack, is 2:24-cv-08204, Stern v. Electrolux Home Products, Inc.
Featured Firms
Law Offices of Gary Martin Hays & Associates, P.C.
(470) 294-1674
Law Offices of Mark E. Salomone
(857) 444-6468
Smith & Hassler
(713) 739-1250