Interview with a Medicaid Audit and Compliance Officer

In response to the recent popular episode with Dr. Roy Shelburne, I decided to reach out directly to my local state Medicaid office to talk to somebody about how criminal medicaid cases are handled. Although I wasn't able to convince any members of the department to join me on the podcast directly, I was able to take and share notes from the conversation. There was a lot of listener feedback with confusion about how a dentist could end up in prison over simple billing and coding errors. I was able to shed a lot of light on that in my conversation with the Medicaid auditor.  I also give my thoughts on a recent Medicaid fraud/kickback scheme involving the indictment of two individuals at a Texas pediatric dental office involving 6 million dollars worth of fraudulent and criminal dental billing to Medicaid (allegedly).