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NYS Comptroller


Taxpayers' Guide to State and Local Audits

Department of Health
Medicaid Payments for Dental Consultations (Follow-Up)

Issued: November 27, 2012
Link to full audit report 2012-F-27
Link to 30-day response

To determine the extent of implementation of the three recommendations included in our initial audit report, Medicaid Payments for Dental Consultations (Report 2010-S-12).

Our initial audit report, which was issued on September 30, 2010, examined Medicaid payments to dental specialists for consultation services. Based on a statistical analysis of a sample of claims paid to the ten dental specialists with the highest Medicaid reimbursements during the original audit period (March 1, 2005 through February 10, 2010), we estimated that the claims for these specialists alone accounted for at least $1.2 million of Medicaid overpayments to as much as $1.3 million. We concluded that if these results held true for the claims of all other providers of dental consultations during our audit period, then New York's Medicaid program overpaid an additional $2.6 million. We recommended that the Department seek recoveries as appropriate and request the Office of the Medicaid Inspector General to determine whether fraudulent billing has been taking place. We also recommended the Department remind dentists that it is not appropriate to bill for a dental consultation when a patient is transferred to them for routine dental care.

Key Findings

  • Department officials have made significant progress in correcting the problems we identified in the initial report. All three recommendations have been implemented.

Key Recommendations

  • None

Other Related Audits/Reports of Interest
Department of Health: Medicaid Payments for Dental Consultations Report 2010-S-12
Department of Health: Medicaid Payments for Excessive Dental Services Report 2009-S-46

State Government Accountability Contact Information:
Audit Director: Brian Mason
Phone:(518) 474-3271; Email:
Address: Office of the State Comptroller; Division of State Government Accountability; 110 State Street, 11th Floor; Albany, NY 12236