Posted: Wednesday, August 22nd 2007 at 4:40am
Kool Smiles patients file class-action lawsuit against care organizations
By The Associated Press
Parents of children who receive Medicaid or PeachCare dental treatment from a large dental care provider filed a class action lawsuit Wednesday in federal court against Georgia's community health commissioner and two managed care organizations in an attempt to preserve the children's access to dental care.
The lawsuit, filed in U.S. District Court in Rome, Ga., requests an injunction that would prevent WellCare and Peach State Health Plan from terminating the contracts of dental providers Kool Smiles and Help A Child Smile until the organizations can demonstrate the contract terminations will not interfere with the requirements for operating Medicaid dental programs.
The contracts, which allow the providers to provide dental care for children enrolled in Medicaid or PeachCare, which is Georgia's health insurance program for low-income children, are expected to end later this month. Kool Smiles is based in Atlanta; Help A Child Smile is based in Conyers, Ga.
"Given the large volume of patients that are served by these two organizations, it is estimated that well over 50,000 low-income children will be unable to obtain access to the dental care to which they are legally entitled," the lawsuit reads.
But the Georgia Department of Community Health, whose commissioner _ Rhonda Medows _ was named in the lawsuit, disputed that claim in a news release on Wednesday. The state agency previously said parents may sign up affected children for Medicaid dental service through other dentists nearby.
"No child in our Medicaid or PeachCare for Kids programs has lost dental benefits or been dropped from the program due to the contract disputes between Kool Smiles, P.C., and the care management organizations," the state agency said.
David Bear, spokesman for Smyrna, Ga.-based Peach State Health Plan, said Wednesday that his organization had not yet seen the lawsuit.
"There never has been an issue with access _ there always has been access to our members," he said.
The Department of Community Health also announced Wednesday that Kool Smiles was being investigated because of complaints from patients' parents and other dentists "concerning poor care delivery."
The department said it would investigate allegations and concerns that include over-utilization of services, stainless steel crowns and X-rays, unusual patterns of patient restraint and lower use of preventive care, or using fewer sealants for cavity prevention per patient treated.
Dr. David Strange, Kool Smiles' chief dental officer, said the agency's announcement was a "week and feeble attempt" to draw attention away from the problem of proper dental access for low-income children. He said the dental company follows the guidelines of the American Academy of Dentistry.
"This is the first time quality has been raised as an issue after Medicaid patients file a class action lawsuit," Strange said. "Kool Smiles was not terminated for cause _ this was a business decision. Our doors are open; we welcome an inspection, we hold ourselves accountable."
The state agency also said its inspector general began in March an audit of Kool Smiles but would not comment on that investigation until the audit is complete.
Associated Categories: State News
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