Attorney General Josh Stein Announces Nearly $500,000 Settlement Over Medicaid Fraud
Release date:
4/27/2018
(RALEIGH) Attorney General Josh Stein today announced a settlement with Dr. Carlos J. Privette, D.D.S., a dentist in Cary, over the submission of fraudulent claims to the North Carolina Medicaid program. Claims were submitted on Dr. Privette’s behalf for inhalation of nitrous oxide, performance of full mouth debridements, performance of limited and complete oral evaluations, and the surgical removal of teeth from Medicaid recipients. It has been alleged that these services were not medically necessary and/or had no supporting clinical documentation. Dr. Privette will pay the North Carolina Medicaid Program $470,000 in restitution.
“Providing unneeded services defrauds the taxpayer and may put patients at unnecessary risk,” said Attorney General Josh Stein. “My office will not allow it.”
The investigation and settlement stemmed from Medicaid Investigations Division’s continuing focus on Medicaid dental providers within the program who are engaged in fraudulent practices involving a wide variety of services including, but not limited to, dental cleanings, use of nitrous oxide, repetitive restorations on the same tooth, palliative care, and upcoding of patient examinations. This settlement was obtained with the assistance of the North Carolina Department of Justice, Medicaid Investigations Division and the North Carolina Department of Health and Human Services, Division of Medical Assistance – Clinical Policy and Program Integrity.
Contact:
Laura Brewer (919) 716-6484
###