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National chain of dental clinics to pay $23.9 million, allegedly submitted false claims

Posted at 1:25 PM, Jan 10, 2018
and last updated 2018-01-10 17:59:08-05

A national dental chain linked to two child deaths in Arizona will have to pay nearly $24 million to the United States government and 17 states for submitting false claims to state Medicaid programs.

Department of Justice officials announced Wednesday that the agency has settled False Claims Act allegations against dental company Benevis LLC and more than 130 affiliated Kool Smiles dental clinics. 

The DOJ alleged that between January 2009 and December 2011, Kool Smiles clinics in 17 states knowingly submitted false claims for unnecessary baby root canals, tooth extractions and stainless steel crowns. 

"Billing Medicaid programs for dental procedures that are not necessary contributes to the soaring costs of healthcare," said Acting Assistant Attorney General Chad A. Readler. "When healthcare providers put vulnerable patients at risk by performing medically unnecessary procedures to achieve financial goals, we will take action."

Benevis/Kool Smiles released the following statement: "Since 2002, Kool Smiles has been serving underserved communities, and today Kool Smiles provides needed dental care through more than two million patient visits per year, many of whom would not otherwise have access to dental care.  In addition, Kool Smiles dentists have provided more than $128 million in uncompensated dental care to treat patients and families who did not have access to Medicaid dental benefits or other dental insurance, and could not afford to pay. The companies will continue to work toward expanding access to quality dental care for all families."  

KNXV, a Scripps sister station in Phoenix, has actively been looking into Kool Smiles in Arizona, and has discovered two deaths tied to procedures performed at the Yuma office. The deaths are not connected to Wednesday’s settlement. 

Last month, 2-year-old Zion Jay Gastelum died following a visit to Kool Smiles in Yuma.

Zion's uncle said the child's parents took him to Kool Smiles on Dec. 16 for a crown and filling, and somehow either during or after the process, it appears Zion stopped breathing.  

According to family, Zion was transported to Yuma Regional Medical Center and then flown to Maricopa County, where he died several days later. 

Maricopa County Medical Examiner's Office is handling the case and the cause and manner of death remain pending. 

A second death linked to the same dental office was also uncovered. 

Francisca Lares, the mother of 4-year old Lizeth Lares, says her child died after a dental procedure in February of 2016.

According to the family, the 4-year-old girl went into Kool Smiles for dental treatment to deal with an abscess, a tooth was pulled, and then she started showing signs of fever. 

The family took her back to the dentist the next day, but was sent home, and reportedly told that the girl would be fine.

According to court papers, the child died a few days later.