A dental management company and more than 130 of its affiliatesin 17 states have agreed to pay $23.9 million plus interest tosettle civil charges that they fraudulently billed the government formedically unnecessary dental services performed on children, theU.S. Department of Justice announced.

“The allegations in these cases are particularly egregiousbecause they involved medically unnecessary dental servicesperformed on children,” said John H. Durham, U.S. attorney for theDistrict of Connecticut in a statement.

Kool Smiles dental clinics and their parent company, Benevis,formerly known as NCDR, based in Marietta, Georgia, violatedthe federal False Claims Act by billing state Medicaid programs formedically unnecessary baby root canals, tooth extractions andstainless steel crowns, as well as baby root canals that were neverperformed, according to the Justice Department.

During the scheme from January 2009 to December 2011, the KoolSmiles clinics also routinely pressured and incentivized dentiststo meet production goals through a system that disciplined“unproductive” dentists and rewarded “productive” dentists withsubstantial cash bonuses based on the revenue generated by theprocedures they performed, the DOJ said. The clinics ignoredcomplaints about the practice from their own dentists, the agencyadded.

The claims resolved by the settlement were allegations only, andthere was no determination of liability, according to the JusticeDepartment.

A spokeswoman for Benevis did not immediately respond to anemailed request for comment on Friday afternoon.

Three whistleblowers who filed the False Claims Actlawsuits—former Kool Smiles employees Adam Abendano, Poonam Rai andRobin Fitzgerald—will receive a combined $2.4 million for theirshare of the recovery. Of the nearly $24 million payment, about$14.2 million will go to the federal government and about $9.7million to the states, according to the DOJ statement.

Five lawsuits filed under the whistleblower provision of theFalse Claims Act started the investigation. Four cases are pendingin the District of Connecticut and one is pending in the WesternDistrict of Texas, according to the news release.

Special Agent-in-Charge Phillip Coyne of the U.S. Department ofHealth and Human Services Office of Inspector General said: “It isintolerable when health care companies seek to boost profits bydefrauding Medicaid and exploiting children.”

“Systematically performing and billing for medically unnecessarydental procedures undermines the well-being of these youngpatients, corrupts the impartiality of medical decision-making, anddiverts money from taxpayer-funded health care programs designed topay for legitimate medical needs.”

In Connecticut, the investigation was handled by Assistant U.S.Attorney Richard M. Molot.

The cases are: United States, et al., ex rel. Abendano v.NCDR, et al., 3:10-cv-1100 (JBA) (D. Conn.); UnitedStates, et al., ex rel. Greenwald v. Kool Smiles Dentistry,3:10-cv-1100 (JBA) (D. Conn.); United States, et al., ex rel.Rai, et al. v. Kool Smiles Dentistry, 3:17-cv-834 (JBA) (D.Conn.); United States, et al., ex rel. Bowne v. KS-VAP,3:16-cv-369 (JBA) (D. Conn.); and United States, et al., exrel. Alves, et al. v. NCDR, SA-13-CV-0760H (W.D. Tex.).