Ocean Dental Pays $5 Million to Settle Medicaid Fraud Claims

An Oklahoma-based dental company has agreed to pay $5.05 million to resolve a lawsuit claiming it submitted false Medicaid claims. Ocean Dental, which operates 28 dental clinics in seven states, provides dental services to children eligible for Medicaid. The company agreed to the settlement without admitting any wrongdoing, however, a former Ocean Dental employee named in the lawsuit was sentenced to prison time after pleading guilty to health care fraud charges.

511af1fae241eAccording to News OK, Ocean Dental employee Robin Lockwood allegedly submitted false claims to Oklahoma’s Medicaid program between 2005 and 2010 for dental work that was either never provided or billed at a higher rate than the state allows. After pleading guilty in 2012, Lockwood was sentenced to 18 months in prison. She was released in April and will pay $375,000 in restitution.

After the settlement was announced, Ocean Dental released a statement saying that the allegations were centered on an employee (Lockwood) who had not worked at the company since 2010. The company added that it was “glad to get the matter resolved.”

The Ocean Dental case demonstrates that healthcare fraud, specifically Medicaid fraud, extends into the field of dentistry. Dentists are no different than other healthcare practitioners in that they are susceptible to the same kinds of fraud that regularly catch headlines, including:

  • Billing for services never provided
  • Misrepresenting services provided
  • Waiving deductibles or copayments in an effort to build or retain patients
  • Overcharging or upcoding for services
  • Providing unnecessary or incorrect treatments that bring in more money