Maryland will receive $547,423 as its portion of a multi-state and federal settlement with a dental management company accused of submitting bills to state Medicaid programs for medically unnecessary services performed on young recipients of the program.

The settlement of $24 million, plus interest, came with FORBA Holdings LLC of Nashville, Tenn., a dental management company that provided management services to Small Smiles dental clinics nationwide.

According to the state attorney general’s office, Maryland alleged that FORBA was liable for causing the submission of claims for reimbursement for a wide range of dental services for low-income children that were either medically unnecessary or performed in a manner that failed to meet professionally-recognized standards of care. The services included extractions, placing crowns and providing fillings and/or sealants.

As part of the settlement, FORBA agreed to enter into a five-year “corporate integrity agreement” with the U.S. Office of Inspector General of the Department of Health and Human Services requiring the implementation of new procedures and independent reviews. That agreement means that FORBA must engage external reviewers to monitor its quality of care and reimbursement practices, and the firm’s chief dental officer must develop and implement policies and procedures to ensure Small Smiles clinics provide services consistent with professionally recognized standards of care, officials said.

The investigation into the dental firm’s actions came after three whistleblower lawsuits under the False Claims Act, pending in U.S. District Courts in Maryland, Virginia and South Carolina.