The U.S. Department of Justice announced recently that it has achieved a settlement with Kool Smiles dental clinics and their management company, Benevis. The clinics and management company are accused of charging Medicaid programs in 17 states for unnecessary pediatric dental services and for services that were never performed. This allegedly violated the False Claims Act.
In recent years, the government has been taking a much more aggressive approach to health care fraud enforcement, and it looks like enforcement efforts could get even more aggressive under the Trump administration.
Several pharmaceutical companies intentionally misrepresented the degree to which certain drugs and other items were reimbursable under Medicaid, according to the attorney general of another state. The drugs and medical devices were marketed to the state and health care providers as covered outpatient drugs despite being unapproved by the U.S. Food and Drug Administration, the AG alleges, and these fraudulent marketing practices resulted in big gains in market share for the companies.