Earlier this year, Sen. Chuck Grassley of Iowa asked key government agencies what they're doing to prevent and punish Medicaid dental fraud, including billing for unnecessary and painful treatments for children, in light of inspector general audits and related media reports documenting worrisome practices. This week, the Department of Health and Human Services Office of Inspector General notified Grassley that it has excluded two pediatric dentists from federal health programs. One dentist is in Florida. The other dentist is in Colorado. Grassley made the following comment on the exclusions.
"The taxpayers pay for quality health care services. If doctors and dentists are bilking the taxpayers and mistreating patients, they need to be shut out of Medicare and Medicaid, period. The inspector general is right to use this tool whenever it's appropriate."
The Department of Health and Human Services Office of Inspector General provided the following details of the two newly excluded dentists:
On September 30, 2015, OIG excluded Howard Sheldon Schneider, DDS, from participation in all Federal health care programs because his license to practice in the State of Florida was revoked, suspended, or otherwise lost for reasons bearing on his professional competence, professional performance, or financial integrity. OIG conducted an investigation of Dr. Schneider which revealed that the State of Florida Board of Dentistry issued a Final Order for a Disciplinary Voluntary Relinquishment of his dental license after the Florida Department of Health opened an investigation into allegations of Dr. Schneider's abuse of his pediatric dental patients. Dr. Schneider cannot apply for reinstatement until his dental license is reissued by the State of Florida.
On August 12, 2015, Dr. Robert E. Hackley, Jr., DDS, agreed to be excluded from participation in all Federal health care programs for a period of three years. OIG conducted an investigation of Dr. Hackley for dental care he provided to patients at Small Smiles Dentistry for Children in Colorado Springs, Colorado. OIG's investigation revealed that Dr. Hackley furnished dental services to patients of a quality which failed to meet professionally recognized standards of care, including: performing medically unnecessary dental procedures, failing to treat existing dental conditions, and performing dental procedures that were below professionally recognized standards of care.
Grassley's letters to the Justice Department and the Department of Health and Human Services Office of Inspector General from June are available here and here.
In 2013, following a year-long investigation, Grassley and then-Finance Committee Chairman Max Baucus of Montana issued a report and recommendations urging the administration to ban dental clinics from participating in the Medicaid program if the dental clinics circumvent state laws designed to ensure only licensed dentists own dental practices to prevent substandard care. In 2014, the inspector general moved to disqualify a firm from Medicaid.
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