A settlement has been reached in a whistleblower class action lawsuit brought against FORBA Holdings LLC who is accused of causing bills to be submitted to state Medicaid programs for medically unnecessary dental services performed on children insured by Medicaid.
FORBA will pay $24 million, plus interest. The federal share of the civil settlement is $14,285,645, and the states’ Medicaid share is $9,714,355.25. Three whistleblowers will receive payments totaling more than $2.4 million from the federal share of the settlement.
The case stems from three lawsuits that were filed by individual whistleblowers. The United States alleged that FORBA was liable for causing the submission of claims for reimbursement for a wide range of dental services provided to low-income children that were either medically unnecessary or performed in a manner that failed to meet professionally-recognized standards of care. These services included performing pulpotomies (baby root canals), placing crowns, administering anesthesia (including nitrous oxide), performing extractions, and providing fillings and/or sealants.
