Oklahoma Dental Clinics Pay Over $5 Million To Settle Allegations Of False Medicaid Claims For Dental Restoration Procedure
Oklahoma City, Oklahoma -- Sanford C. Coats, United States Attorney for the Western District of Oklahoma and E. Scott Pruitt, Attorney General for the State of Oklahoma, jointly announce that OCEAN DENTAL, P.C, has agreed to pay $5,050,000 to settle civil claims stemming from allegations that it violated the False Claims Act by submitting false Medicaid claims for work that was either never performed or billed at a higher rate than allowed.
"We continually strive to protect government programs, such as Medicaid, from fraud and abuse by ensuring they are used properly and only by those who are in need and are eligible," said U.S. Attorney Sanford C. Coats. "This case is a good example of the value of coordination between state and federal law enforcement, as well as the coordinated use of parallel proceedings, to achieve a successful civil and criminal resolution."
"Preventing fraud is a priority at the Attorney General's Office because fraud limits the ability of those truly deserving of assistance from receiving the help for which they are eligible," said Attorney General Scott Pruitt. "We appreciate partnering with the U.S. Attorney's Office in order to hold accountable those who would perpetrate fraud against the taxpayers."
Ocean Dental operates dental clinics throughout Oklahoma. As part of its practice, Ocean Dental provides dental services to patients, including children, covered by the Oklahoma Medicaid program.
The United States and Oklahoma contend that Ocean Dental submitted false claims for payment to the Oklahoma Medicaid program for dental restorations during the period from January 1, 2005 through September 30, 2010. Specifically, it is alleged that claims for dental restorations furnished to Medicaid beneficiaries by Ocean Dental’s then-employee Robin Lockwood, D.D.S., were false because they were either (1) upcoded by billing for more restored surfaces than were actually performed or (2) not performed at all.
To resolve the civil allegations brought by the United States and Oklahoma, Ocean Dental agreed to pay $5,050,000. Under the Settlement Agreement, Ocean Dental and Chad Hoecker, D.D.S., owner and president of Ocean Dental, are being released from civil liability related to the allegations. Ocean Dental has also entered into a Corporate Integrity Agreement with the U.S. Department of Health and Human Services, Office of Inspector General which requires, among other things, additional record-keeping, reporting and compliance requirements.
"With this settlement, Ocean Dental has agreed to strict new reporting and compliance requirements that will help guard against billing abuses moving forward," said Winston Whittington, Assistant Special Agent in Charge of the OIG’s Dallas office. "Those who perpetrate fraud threaten the health of both the program and the people who depend on it for their care. We will continue to actively pursue these investigations."
In reaching this settlement, Ocean Dental did not admit liability and the government did not make any concessions regarding the legitimacy of the claims. The agreement allows the parties to avoid the delay, expense, inconvenience, and uncertainty involved in litigating the case.
In a separate related criminal case, Dr. Lockwood pled guilty in July of 2012 to committing health care fraud for her role while employed at Ocean Dental. In November of 2012, Dr. Lockwood was sentenced to serve 18 months in federal prison and ordered to pay $375,672.27 in restitution to Medicaid.
This case was investigated by the Federal Bureau of Investigation, the U.S. Department of Health and Human Services, Office of Inspector General, the Oklahoma Attorney General’s Office Medicaid Fraud Control Unit, and the Oklahoma Healthcare Authority. The case was prosecuted by Assistant United States Attorneys Ronald R. Gallegos and Scott Maule, and Oklahoma Assistant Attorney General Niki S. Batt.