Dental Chain Pays $23.9 Million For 'Unnecessary, Expensive Work'

A dental chain has paid $1.7 million million to Massachusetts as part of a national settlement that claims that the company fraudulently billed the state’s Medicaid program for medically unnecessary and expensive dental work on pediatric patients, Attorney General Maura Healey announced.

The payment is part of a $23.9 million global settlement with the United States, the District of Columbia, and 19 other states settling allegations against Benevis LLC (formerly known as NCDR, LLC) and 133 Kool Smiles Clinics across the nation supported by Benevis, including eight in Massachusetts.

“This company made millions by performing unnecessary root canals and other invasive dental procedures on children,” said AG Healey in a statement. “With this settlement, we’re recovering more than $1 million for the state and will ensure this company cannot use these practices in the future.”

Benevis is a private company that provides non-clinical practice support services, such as management of clinic finances and administration, to dentists and dental clinics, including Kool Smiles dental clinics nationwide.

According to the announcement, the settlement resolves allegations that Benevis/Kool Smiles knowingly submitted or caused to be submitted false claims to the Medicaid program related to providing stainless steel crowns, tooth extractions and baby tooth root canals to pediatric patients that were either not medically necessary or where less costly treatment options were available. Of the $23.9 million paid by Kool Smiles to resolve these allegations, $1.7 million is attributable to the Massachusetts Medicaid program, MassHealth.

The settlement also resolves allegations that Benevis/Kool Smiles failed to implement appropriate controls to prevent the overuse of certain procedures, including offering productivity bonuses based on revenue generated by performed procedures, scheduling practices that maximized patient visits per day, and pressuring dentists to meet production goals and terminating those who failed to meet them.

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