For Immediate Release
November 19, 2010
Jeffrey S. Cahill, Senior Assistant Attorney General
Attorney General Michael A. Delaney announces that his Office has reached an agreement with Dr. Frederick W. Salvatoriello, an orthodontist with offices in Claremont, New London, and Hanover, in which Dr. Salvatoriello will repay $225,000 resulting from an investigation concerning charges to the Medicaid program. The agreement resolves an audit of the Medicaid billing codes used by Dr. Salvatoriello's practice when treating more than 1500 Medicaid beneficiaries between 2007 and 2009. Medicaid covers orthodontic care for children that suffer from severe handicapping malocclusions. Comprehensive services require Medicaid prior review and approval. The program does not cover cosmetic procedures.
The audit found that Medicaid made payments for services related to pre-orthodontic visits, palliative treatment, and periodic oral evaluations that were already reimbursed under other codes, including the established rate for comprehensive orthodontic treatment. The audit also disallowed certain claims for limited orthodontic treatment because of insufficient documentation that those services were distinct from the comprehensive orthodontic treatment provided. The provider also charged for functional appliances without obtaining Medicaid's prior approval, incorrectly believing the appliances qualified as space maintainers and were therefore exempt. Finally, the audit determined that Dr. Salvatoriello was not entitled to certain evaluation fees for patient x-rays and models that were submitted to the State for prior approval of services. There was no allegation of any intentional wrongdoing. Dr. Salvatoriello fully cooperated with the audit.
New Hampshire Department of Justice | 33 Capitol Street | Concord, NH | 03301