NY clinic pays $115K to settle Medicaid violations

A dental clinic run by the State University of New York in Buffalo will pay $115,094 to settle Medicaid billing violations.

Improper billing linked to the settlement occurred between January 2005 and August 2009 at the Daniel Squire Oral Diagnostic & Treatment Center on the university's campus in Buffalo, according to statement by New York State Attorney General Eric Schneiderman.

Medicaid billing rules require dental clinics to perform a cleaning, dental exam, and x-rays (if required) during a single reimbursable visit with a patient, unless there is a specific reason -- recorded in the patients' record -- why these services must be performed over multiple visits.

During its audit-investigation, the attorney general's office determined that, in some cases, the dental clinic performed such services over two separate visits without noting the reason in the patient record and billed Medicaid for each visit. As a result, the clinic received double reimbursement from Medicaid for the services.

In other cases, the clinic kept insufficient records to show it performed services it claimed to have rendered to patients, which also was in violation of Medicaid billing rules, the attorney general's office said.