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[MM Curator Summary]: Unnecessary root canals on babies. Medicaid fraud is real and obscene folks, and you are paying for it with every paystub.
An area dentist must fork over $750,000 to settle a massive Medicaid fraud involving unnecessary root canal procedures on children.
Destiny Deffo, Creative Commons
A dentist with practices all over the tri-state area has reached a $750,000 settlement in relation to a Medicaid scam involving unnecessary “baby root canals” performed on children, the New York Attorney General announced Thursday.
Dr. Barry L. Jacobson, a pediatric dentist with 13 practices, including two in Brooklyn, will have to fork over the substantial sum to the feds and the states of New York and New Jersey for defrauding the federal government via systematic overbilling practices, wherein dentists performed medically unnecessary “pulpotomies” on children in order to submit claims to Medicaid, sometimes with bogus provider info.
Jacobson and his management company, HQRC Management Services, owe $432,345.95 to New York State, $313,783.17 to the feds, and $7,328.79 to New Jersey. In total, Jacobson is on the hook for $753,457.91.
“Dr. Jacobson and HQRC allegedly performed unnecessary and invasive dental procedures on children to line their own pockets,” said New York Attorney General Letitia James in a statement. “My office will not tolerate any instance of medically unnecessary procedures performed on vulnerable Medicaid beneficiaries.”
Pediatric Dentistry on Avenue U, one of two Brooklyn locations in Jacobson’s toothy empire.Google Maps
Dentists employed by Jacobson — whose toothy empire includes practices in Borough Park (Pediatric Dentistry of Boro Park) and Sheepshead Bay (Pediatric Dentistry on Ave U) — on several occasions performed pulpotomies on young children despite their medical records not supporting the need for one, James and New Jersey US Attorney Philip Sellinger said.
A pulpotomy, also known as a “baby root canal,” is a procedure done on infected baby teeth. In the procedure, a dentist removes damaged nerve tissue, or “pulp,” from a tooth and caps it with a crown or filling. Although children eventually lose their baby teeth, dentists may perform a pulpotomy instead of extracting the tooth because premature loss can cause the adult tooth to grow crooked.
An undisclosed number of children, however, received pulpotomies at Jacobson’s practices on teeth that did not display any signs of decay, according to dental records obtained by investigators.
The scheme came to the attention of authorities by a former employee, Lauren Simpson, who acted as an informant to investigators. Simpson will receive $135,622 of the settlement proceeds.
HQRC did not respond to a request for comment.
Clipped from: https://www.brooklynpaper.com/dentist-reaches-750k-settlement-in-medicaid-fraud-suit-over-unnecessary-baby-root-canals/