Advantage Dental to Pay $4.5 Million to Settle Oregon Health Plan Billing Allegations

Oregon — Advantage Dental Services, LLC will pay $4.5 million to settle allegations that it improperly billed the Oregon Health Plan for thousands of patient phone calls that state officials say did not provide legitimate dental counseling.

Attorney General Dan Rayfield announced the agreement October 2. The settlement includes $2.25 million in restitution and $2.25 million in penalties. Advantage Dental cooperated with the investigation but denies the allegations, and the agreement is not an admission of wrongdoing, according to the Oregon Department of Justice.

The state and Oregon Health Authority alleged that, from January 2020 through December 2025, the company recorded calls as nutrition and oral hygiene counseling even though they did not include substantive dental advice or patient consent.

Those claims allegedly helped Advantage Dental meet performance and quality targets in its contracts, qualifying the company for annual incentive payments funded by Medicaid. State officials said the company would not have received much of that money without the disputed claims.

The allegations concern both how the calls were recorded and their effect on incentive payments. By counting the calls as patient counseling, the company allegedly increased the reported activity used to determine whether it had met contractual targets.

Rayfield said the case reflected the state’s responsibility to ensure taxpayer funding pays for actual health care services.

The Oregon DOJ’s Medicaid Fraud Control Unit investigated the case. The unit investigates Medicaid provider billing fraud and abuse or neglect connected with health care services. Suspected Medicaid provider fraud can be reported to Fraud.Referral@doj.state.or.us.

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