The United States Attorney's Office

INTERDENT AND DEDICATED DENTAL PAY MORE THAN $375,000 TO SETTLE CIVIL ALLEGATIONS OF DEFRAUDING MEDI-CAL PROGRAM

InterDent, Inc., InterDent Service Corporation and Dedicated Dental Systems Corporation have paid the United States $377,470 to resolve allegations that the Bakersfield-based Dedicated Dental knowingly submitted false claims for orthodontic care to Medi-Cal’s dental program, which is called Denti-Cal.

InterDent and Dedicated Dental also have paid the State of California $351,530 to resolve similar allegations. Interdent and Dedicated Dental agreed to resolve the allegations against them without an acknowledgment of wrongdoing.

United States District Judge Ronald S.W. Lew finalized the settlement when he unsealed a “whistleblower” lawsuit earlier today. 

The Medi-Cal program is funded by both the United States and the State of California. Medi-Cal provides health care services to certain patient groups, mainly the poor and disabled. The Denti-Cal program reimburses for orthodontic care provided to Medi-Cal beneficiaries under the age of 18.  The orthodontic care must be provided by certified orthodontists who are enrolled in the Denti-Cal program.

The lawsuit in this case was originally filed in June 2005  by Dr. Guy W. Mendivil pursuant to the qui tam provisions of the federal False Claims Act and the California False Claims Act. Dr. Mendivil is a certified orthodontist and an enrolled Denti-Cal provider who worked at Dedicated Dental’s orthodontic clinic on San Dimas Street in Bakersfield. Dr. Mendivil alleged that from 2002 through 2005, the Dedicated Dental clinic used his Denti-Cal provider number to bill the Denti-Cal program for orthodontic care provided by unauthorized dentists. These dentists allegedly were unauthorized either because they were not enrolled in the Denti-Cal program at the time they provided the services, they were excluded from the Denti-Cal program, or they were not certified orthodontists.

A qui tam lawsuit is a civil action, commonly called a “whistleblower” lawsuit, that is filed by a private party called a relator. The lawsuit is filed under the federal False Claims Act on behalf of the United States and, in the case of the alleged Medi-Cal fraud, also can be filed under the California False Claims Act on behalf of the State of California. The action, which is initially filed under seal, must allege the submission of false claims seeking payment from the government. The U.S. Department of Justice is given an opportunity to review the allegations to decide whether to intervene and prosecute the case on behalf of the United States. The United States and the State of California elected to intervene in Dr. Mendivil’s lawsuit for the purpose of settling it. Pursuant to the settlement negotiated in this case, the United States and the State of California have agreed to seek the dismissal of the federal and California False Claims Act causes of action.

This case was handled jointly by the United States Attorney’s Office in Los Angeles and the California Attorney General’s Office, Bureau of Medi-Cal Fraud and Elder Abuse, in San Diego and Sacramento. These offices received assistance from investigators from the Bureau of Medi-Cal Fraud and Elder Abuse and the Federal Bureau of Investigation and attorneys from the Office of Counsel to the Inspector General for the U.S. Department of Health and Human Services and the California Department of Health Care Services.

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