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Operation Root Canal: High Point Dentist Must Pay $567,125 In Settlement For Unnecessary Procedures, Medicaid Fraud: NCDOJ

Operation Root Canal is an investigation by the NCDOJ’s Medicaid Investigations Division to stop fraud among dental providers.

HIGH POINT, N.C. — A High Point dentist must pay up after submitting false claims to the state’s Medicaid program and providing unnecessary procedures, according to the North Carolina Attorney General’s Office.

The dentist, Dr. Stefan J. Simoncic with Triad Oral Surgery will have to pay $567,125 as part of the settlement. It’s the result of Operation Root Canal, an investigation by the NCDOJ’s Medicaid Investigations Division to stop fraud among dental providers.

The settlement reveals between Jan. 1, 2015 and August 31, 2019, Dr. Simoncic submitted claims involving detailed oral evaluations and anesthesia services performed on Medicaid recipients. The state reveals the services was not medically necessary, did not provide supporting clinical documentation, or were performed in violation of Medicaid policy.

The Attorney General’s Office said Operation Root Canal involves a wide variety of dental services, including dental cleanings, use of nitrous oxide, repetitive restorations on the same tooth, palliative care, and upcoding patient examinations.

The state has now reached settlements with 10 dental providers resulting in more than $6.3 million being paid back to the Medicaid program.

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