OIG Receiving Complaints Against Dentists Alleging Substandard and Unnecessary Procedures As Well As Case Management Irregularities

The latest OIG Quarterly report was released last month. It contains several important trends for dentists and trends in OIG investigations into dental practices.

Firstly, OIG preliminary investigations into dentists and dental practices remain at their traditional level of 6%, well behind home health agencies, physicians and attendants.  However, the number of full-scale investigations launched by OIG into dentists has skyrocketed up to 14% of all provider investigations that get to that level.  This is up from 5% of full-scale investigations in the last Quarterly report.

Dentists are now the second most investigated group behind home health agencies.

These full-scale investigations may be because

“The OIG Intake and Resolution Unit (IRU) continues to receive complaints against dentists and endodontists alleging substandard and unnecessary procedures, which potentially impact patient care.

“The OIG is investigating these providers and recommending administrative actions based on findings. IRU has also received complaints related to case management services, which must be performed by either a licensed social worker or registered nurse, that allege duplicate billing, services performed by uncredentialed or unlicensed providers and records not supporting the services billed.”

There were no specific cases involving dentists mentioned in the report as is sometimes included.

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