Tuesday, February 16, 2016

Boston Dentist to Pay $650,000 in Civil Settlement for Improper Medicaid Billing

A Boston dentist has agreed to pay $650,000 to the state’s Medicaid program (MassHealth) to resolve allegations of improperly billing for dental work at her offices in Everett, South Boston.
The January 29, 2016 settlement resolves allegations that from February 2007 through July 2012, Dr. Ekaterina Mamulashvili and her professional dental practices improperly and frequently used multiple oral examination codes to bill MassHealth for services received by the same patients on the same day.

The matter was referred to the Attorney General's (AG) Office by MassHealth after an audit uncovered concerns about Dr. Mamulashvili’s billing practices. An audit of dentists and dental practices done by the State Auditor also found issues with billing for oral examinations, including with Dr. Mamulashvili’s practices.

The AG’s Office conducted an extensive investigation into Dr. Mamulashvili and her professional dental corporations, Everett Dental Management Corporation, Sameka Dental Management Corporation in South Boston, and Malden Dental Management Center, Inc.

Under the terms of the civil settlement, Mamulashvili and her businesses will pay MassHealth $650,000 as restitution for improper billing. The settlement also requires that Mamulashvili, her employees to review and comply with all applicable state and federal statutes, and all regulations governing participation in MassHealth.

These audits in California are handled by Delta Dental and a civil settlement is certainly preferable to any criminal investigation or referral. 

Posted by Tracy Green, Esq.
Green and Associates, Attorneys at Law


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