Audit of Massachusetts Medicaid Program Reveals Questionable Claims

Dental providers in Massachusetts may have made some faulty Medicaid claims.

A state audit has found that about $1.3 million in bad medical claims were made from January 2008 through June 2011.

The auditor, Suzanne Bump, claims that MassHealth needs to be more thorough when screening payments from dental providers.

Many of the questionable charges stem from detailed oral screenings, which are only allowed for patients undergoing radiation, chemotherapy or organ transplant, according to MassHealth regulations.

The audit, however, discovered that 10 dental providers billed that state and received payments for about 20,000 oral screenings involving patients not eligible for these types of oral screenings.

Roughly 2,000 dentists took part in the state’s dental program during the audit period

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