Dental management firm agrees to $3 million penalty
<p style="margin: 0in 0in 0pt;" class="BODY">An Effingham-based company that manages dental practices in Springfield, Lincoln, Litchfield and dozens of other Illinois communities will pay more than $3 million to resolve allegations of Medicaid fraud and improper prescription writing that arose from a federal whistle-blower lawsuit.
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<p style="margin: 0in 0in 0pt;" class="BODY">The settlement, involving Heartland Dental Inc. and Heartland chief executive officer Richard E. Workman, was announced Friday by the Springfield office of Rodger Heaton, U.S. attorney for the Central District of Illinois.
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<p style="margin: 0in 0in 0pt;" class="BODY">Heartland Dental denied any wrongdoing as part of the civil settlement, and Deborah Gersh, one of the company's lawyers, noted that federal officials made no allegations that any dental procedures were performed unnecessarily or caused any harm to patients.
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<p style="margin: 0in 0in 0pt;" class="BODY">In the first of civil settlements to resolve the allegations, Heartland agreed to pay $1.65 million - $990,000 to state government and $660,000 to the federal government - to resolve allegations of improper billings to Illinois' Medicaid program.
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<p style="margin: 0in 0in 0pt;" class="BODY">In a related settlement, Heartland agreed to pay the federal government $1.35 million to resolve allegations that newly hired dentists in Illinois and other states issued prescriptions for painkillers and antibiotics before those dentists underwent the required federal registration.
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<p style="margin: 0in 0in 0pt;" class="BODY">According to the U.S. attorney's office, the first settlement resolved allegations that Heartland submitting claims to Medicaid for tooth restorations when the procedures performed were actually "crown buildups," which don't qualify for coverage.
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<p style="margin: 0in 0in 0pt;" class="BODY">It also was alleged that the company wrongly billed Medicaid tooth extractions as "surgical extractions" - procedures that resulted in higher payments.
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<p style="margin: 0in 0in 0pt;" class="BODY">Federal officials said the alleged improper Medicaid bills took place from 1999 through October 2005.
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<p style="margin: 0in 0in 0pt;" class="BODY">Heartland Dental manages more than 60 dental offices in Illinois, including several in Springfield and locations in Lincoln, Litchfield, Peoria, Rockford and the Chicago area. About 15 of Heartland Dental's Illinois offices serve the bulk of the company's Medicaid patients, according to Chad Thompson, vice president of administration.
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<p style="margin: 0in 0in 0pt;" class="BODY">Thompson said the settlements won't jeopardize the company's ability to continue to serve Medicaid patients.
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<p style="margin: 0in 0in 0pt;" class="BODY">Under the terms of federal and state laws that encourage citizens to report fraud and allow them to be rewarded, former Heartland employee Lori Jamison will receive $412,500 from the federal government's $660,000 settlement.
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<p style="margin: 0in 0in 0pt;" class="BODY">Jamison also will be paid an additional $325,000 by Heartland to take care of her attorney's fees and related costs.
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<p style="margin: 0in 0in 0pt;" class="BODY">Jamison, who used to work for one of the companies that merged in 2006 to form Heartland, filed a whistle-blower lawsuit in 2003. That suit, which had been sealed, was unsealed and dismissed Friday in Springfield's U.S. District Court.
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<p style="margin: 0in 0in 0pt;" class="BODY">Neither Jamison nor her attorney, Ronald Osman of Marion, could be reached Friday. It's unknown where Jamison lives, but federal officials said she doesn't live in the Springfield area.
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<p style="margin: 0in 0in 0pt;" class="BODY">Dean Olsen can be reached at (217) 788-1543.