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Thursday
Jan112018

Kool Smiles Reaches $23.9M Deal on Unneeded Services

The U.S. Department of Justice said a $23.9 million voluntary settlement has been reached with Benevis LLC and Kool Smiles Dental Clinics after allegations surfaced claiming medically unnecessary services were performed on children.

According to officials, Kool Smiles clinics in 17 states submitted false Medicaid claims for "baby root canals," tooth extractions, stainless steel crowns and other procedures which were unnecessary for the pediatric patients between January 2009 and December 2011.

An investigation was launched after former Kool Smiles employees filed lawsuits under the whistleblower provision of the False Claims Act.

"Such claims include, but are not limited to, stainless steel crowns placed on primary teeth that were likely to exfoliate on their own without intervention or stainless steel crowns placed on teeth when no pain was reported," the settlement states.

The settlement also states pulpotomies, or the removal of part of the tooth pulp, were performed when less expensive and less intensive treatments would have been appropriate. The affected Kool Smiles Clinics are also accused of submitting claims for pulpotomies that were never performed.

More than 130 clinics operated by Benevis, including Kool Smiles locations in the Upstate, are part of the settlement. The following Upstate Kool Smiles locations are named in the documents:

  • 31112 North Main Street in Anderson
  • 3227 W. Blue Ridge Drive in Greenville
  • 629 Highway 28 Bypass in Anderson
  • 3 K-Mart Plaza in Greenville

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