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ACCC frowns at smile health rebate claims

Dental News by Dental News
July 13, 2021
in Orthodontics
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ACCC frowns at smile health rebate claims
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Pricey teeth straightening involved crooked claims, according to the consumer watchdog which is taking a teledentistry to court.

SmileDirectClub customers use in-home kits or visit the company’s retail shops before receiving teeth aligners for about $3000.

But the Australian Competition and Consumer Commission on Tuesday said SDC left consumers believing some of the orthodontics could be reclaimed through private health insurance.

SDC said the treatment could be covered under two item codes when most Australian funds only pay out if a dentist or orthodontist sees the patient face-to-face, the ACCC alleges.

More than 600 customers were allegedly individually emailed “good news about your health fund” covering the treatment.

But the ACCC says SDC had only checked the relevant fund covered the two item codes, not that the health fund would cover cost of the SDC products.

From May 2019 to October 2020, at least 26,3000 consumers commenced the aligner treatment and paid between $2825 and $3155 in circumstances where those with private health insurance “may not have done so if they had known that they were not entitled to reimbursement”, the ACCC says in a statement of claim filed in the Federal Court.

“It is a breach of Australian Consumer Law for companies to make false or misleading statements about the benefits or rights associated with products and services,” ACCC chair Rod Sims said in a statement.

SDC said it was disappointed with the action, which has nothing to do with the safety and efficacy of its treatment.

“SmileDirectClub has established partnerships with many of the largest private health insurance companies in the United States, Canada and the EU to ensure the access to orthodontic care it enables is a covered treatment and is even more affordable to consumers,” a spokesman told AAP in a statement.

“It continues to be our position that this should be true in Australia.”



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