Chain of Dental Clinics Barred from Medicaid After Investigation Finds Widespread Negligence

A chain of pediatric dental providers are banned from participating in federal health care programs after the group repeatedly provided unnecessary medical care to children and failed to meet recognized standards of care. Nashville-based CSHM, LLC, which provided care to hundreds of thousands of children, also failed to report serious quality-of-care events and take corrective actions as required by federal law, according to a recent announcement by the Office of Inspector General.

The barring comes after years of shoddy medical practice allegations against the chain, including findings by the U.S. Justice Department that it was performing unnecessary and substandard procedures on low-income children. CSHM, LLC, formally known as Church Street Health Management, manages and operates the national chain of Small Smiles Dental Centers, which provides services to pediatric patients on Medicaid.

In some cases, parents said their children were subjected to needless procedures such as root canals and filings and that proper pain management was neglected. The improper medical care led to some children suffering ongoing pain and chronic dental trouble. CSHM signed a 2010 settlement with the Justice Department in which the company agreed pay the government $24 million to resolve the government’s allegations. CSHM also sighed a Corporate Integrity Agreement (CIA), stating it would alter its practices and improve quality of care.

But subsequent monitoring and investigations determined the chain did not stick to the agreement. The OIG found CSHM failed to report serious quality-of-care reportable events, did not make notifications of those events to state dental boards, failed to implement and maintain key quality-related policies and refused to properly maintain a log of compliance disclosures. CSHM also submitted a false certification regarding its compliance with CIA obligations.

The barring of CSHM from federal programs goes into effect Sept. 30, 2014. In the meantime, an independent monitor will continue to monitor the quality of care being provided to patients at CSHM clinics.

All states are required to provide dental benefits to children covered by Medicaid and the Children’s Health Insurance Program (CHIP). The Early and Periodic Screening, Diagnostic and Treatment benefit provides comprehensive and preventative health care services for children under 21 enrolled in Medicaid. Parents should ensure they know how to access dental help for their children and how to report suspected Medicaid fraud. Patients and their families are entitled to legal relief if they are victims of dental malpractice.

 

Related Articles

Malpractice Lawsuit Against Miami Hospital After Unnecessary Circumcision
Knee Surgery Not Always Necessary
Why Doctors Rush Procedures
Photo Credit: Alex E. Proimos cc