Southwest Washington dental practice settlements total $1M to resolve Medicaid fraud claims

Three dental practices in Southwest Washington reached settlements totaling more than $1 million to resolve allegations that they engaged in fraudulent billing practices that overcharged the Medicaid program.

"Accuracy and honesty from healthcare providers are fundamental to the integrity of the Medicaid system and our ability to help people get the care they need," Attorney General Nick Brown said. "These settlements are one piece of our many efforts to safeguard the Medicaid program from fraud and abuse."

The following dental practices reached settlements with the Washington Attorney General's Office Medicaid Fraud and Abuse Division (MFA) following investigations that found they had submitted unjustified charges to Medicaid:

• Toothdocs, a dental practice in Camas, agreed to a $500,000 civil settlement to resolve claims that 100% of the provider's billings for so-called parenteral medicaments, which are drugs that are not taken orally, were actually for over-the-counter doses of ibuprofen. The miscoded billings from October 2017 to March 2023 resulted in more than $370,000 in unjustified charges to Medicaid.
• Comfort Dental Vancouver reached a $230,000 civil settlement to resolve similar allegations of billing Washington Medicaid for parenteral medicaments when the services involved over-the-counter ibuprofen instead. The investigation found that the miscoded bills resulted in about $153,000 in Medicaid losses.
• Dentist at Felida, in Vancouver, agreed to a $360,300 civil settlement to resolve claims the practice's improper billing led to about $212,000 in Medicaid losses. The investigation found the dental practice submitted bills for palliative (emergency pain) treatments and jawbone procedures without proper documentation or medical necessity.

Established in 1978, the Washington State Medicaid Fraud & Abuse Division (MFA) is responsible for criminal and civil investigations and prosecutions of health provider fraud, abuse committed in connection with Medicaid services, and resident abuse or neglect in long-term residential care.

Since October 2018, MFA has charged 127 criminal cases and obtained 104 criminal convictions. Additionally, MFA recovered approximately $81 million on behalf of the Medicaid program through its civil prosecutions.

The Washington Medicaid Fraud & Abuse Division receives 75% of its funding from the U.S. Department of Health and Human Services under a grant award totaling $11,500,040 for federal fiscal year 2026. The remaining 25%, totaling $3,833,344, is funded by Washington state Medicaid fraud recoveries.

The settlements are the result of the MFA team, including Assistant Attorney General Naomi Smith, Data Scientists David McDonald and April Minton, and Paralegal Tay Pittman.

Copies of the settlements are available here: Toothdocs, Comfort Dental Vancouver, Dentist at Felida.

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