Massachusetts § 52E - Repeated irregularities in billing third party payers; disciplinary proceedings

§ 52E. Repeated irregularities in billing third party payers; disciplinary proceedings

Section 52E. The board, after due notice and hearing, may suspend, revoke, cancel or reprimand the holder of any certificate, registration, license or authority issued by it, of any dentist whom it finds has engaged in repeated irregularities in billing an insurance company or other third party payer for services rendered to a patient.

For the purposes of this section irregularities in billing shall include: reporting charges for the purpose of obtaining a total payment in excess of that usually received by the dentist for the services rendered; falsely reporting treatment dates for the purpose of obtaining payment; reporting charges for services not rendered; falsely reporting services rendered for the purpose of obtaining payment; or abrogating the copayment provisions of a contract by accepting the payment received from the third party payer as full payment.

Any person aggrieved by the action of the board by a suspension, revocation, cancellation or reprimand under this section of any certificate, registration, license or authority issued by it may appeal such action under the provisions of section fourteen of chapter thirty A.