Boston Dentist to Pay $650,000 to MassHealth Over Improper Billing
BOSTON – 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, and Malden, Attorney General Maura Healey announced today.
The 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.
“We allege this dentist knowingly and frequently overbilled MassHealth by improperly using multiple oral examinations codes in violation of state law,” AG Healey said. “This settlement will provide restitution to MassHealth, and will ensure that taxpayer dollars are used to benefit members, not to enrich providers.”
The matter was referred to the AG’s 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.
The case was handled by Assistant Attorney General Brendan O’Shea, Investigations Supervisor Lisa Bailey, and Investigator Ronald Velez, all of AG Healey’s Medicaid Fraud Division.