The Department of Health & Human Services' Office of Inspector General (OIG) released a report of an analysis of Medicaid payments in the State of Louisiana for pediatric dental services.
Specifically, OIG studied those providers who provided services to 50 or more children in 2012. It found that 5% of the dental providers – an oral surgeon as well as 26 general dentists – had extremely high payments per child; an extremely large number of services per day; and/or an extremely high number of services per child per visit. This raised concerns that the services were not medically necessary or that they were never provided.
As a result, OIG recommended that Louisiana enhance its monitoring of dental providers, identify patterns of questionable billing and take appropriate action.
Simply put, the report re-emphasizes the fact that OIG continues its efforts to identify fraud and abuse. Stated differently, providers of questionable services, even those services performed years ago, remain at risk. Presumably, OIG will continue to focus on dental providers moving forward.
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