TennCare requires dentists to get approval before billing for dental services as part of a credentialing process that ensures Medicaid patients receive care from competent providers, according to a July 26 news release from the Justice Department.
Don Flanagan, DDS, is the former owner of Cloudland Dental, which has locations in Chattanooga, Cleveland, Crossville, and Sweetwater, Tenn. From January 2015 through February 2019, the practice allegedly knowingly submitted or caused to be submitted claims that identified Dr. Flanagan as the provider of dental services that were actually given by uncredentialed dentists who were ineligible to bill TennCare.
The settlement is the result of a 2019 lawsuit filed under whistleblower provisions of the False Claims Act and Tennessee Medicaid False Claims Act. The individual who filed the lawsuit will receive $255,850 of the settlement.
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