Attorney General Reaches $728k Settlement in Medicaid Fraud Case

Dentistry Today

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North Carolina Attorney General Josh Stein has reached a $728,450 settlement with Zhanying Guo, DDS, and her dental practice, Complete Dental Care of Mebane, over allegations of Medicaid fraud. Specifically, the settlement alleges that Complete Dental Care of Mebane submitted fraudulent claims to the North Carolina Medicaid program between 2013 and 2018.

“When people chat the Medicaid system, they cheat taxpayers and people who need and deserve health care,” said Stein. “My office will continue our work to fight against these misdeeds.”

According to the allegations, claims submitted to Medicaid were not medically necessary, had no supporting clinical documentation, were not performed, or were performed in violation of Medicaid policy. Under the settlement, Guo and Complete Dental Care have agreed to pay $728,450 in damages and penalties.

The investigation and settlement stemmed from the North Carolina Department of Justice’s Medicaid Investigations Division’s work to find Medicaid dental providers who are engaged in fraudulent practices involving a wide variety of services including dental cleanings, use of nitrous oxide, repetitive restorations on the same tooth, palliative care, and upcoding of patient examinations. 

The settlement was obtained with the assistance of the North Carolina Department of Justice, Medicaid Investigations Division, and the North Carolina Department of Health and Human Services, Division of Medical Assistance-Clinical Policy and Program Integrity.

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