Monday, August 29, 2016

TOXIC TROIKA FOR DENTAL PATIENTS: Collusion Between Corporations, Government and Organized Dentistry Maximizes Healthcare Profits

Dr. Michael Davis
Dr. Michael W. Davis maintains a general dental practice in Santa Fe, NM. He serves as chairperson for Santa Fe District Dental Society Peer-Review. Dr. Davis also provides a fair amount of dental expert legal work for attorneys. He may be contacted via email: MWDavisDDS@comcast.net




TOXIC TROIKA FOR DENTAL PATIENTS: Collusion Between Corporations, Government and Organized Dentistry Maximizes Healthcare Profits
Introduction
 
The US healthcare industry is corrupted by crony capitalism1 of government special treatment and favoritism, from big corporate healthcare political donors. A classic example is the McCarran-Ferguson Act of 19452, which exempts the healthcare insurance industry from federal antitrust regulation and statutes, which every other American industry must comply with. Insurance industry lobbyists have successfully defeated repeal attempts, throughout multiple decades of different political administrations. Money talks in Washington regardless of political party.

In the dental healthcare industry specifically, we’ve witnessed countless examples of government support for big business interests. The donor class3 of major political parties doesn’t care about labels such as Republican or Democratic. They expect special treatment and favoritism from government, for the moneys they pay in.


Examples of Dental Industry Crony Capitalism
 
In 2012, North Carolina attempted to establish statutes to protect the doctor/patient relationship, and a patient’s right to full disclosures within the dental informed consent process. The state was met with a heavy barrage of out-of-state big dollar opposition from the dental service organization (DSO) industry. (Author’s note: “Dental Service Organization” is an intentional misnomer created by this industry, which either beneficially owns dental clinics, or is subordinate to private equity investment groups which do. The allegation of support limited strictly to non-clinical services, and not patient care, is a bogus claim.4) Republican lobbyist old-boys Jeb Bush, Haley Barbour, Bill First, Tommy Thompson, Grover Norquist, and many others descended en masse into North Carolina, for this test case state legislation.5,6 
 

The private equity investment industry, which controls most of corporate dentistry, pulled out all the stops. They funded a massive advertising campaign of misinformation relating to “access to care” and low-cost dental treatment. Through DSO industry lobbyists and private equity investment firms, “donation” dollars flowed to local state politicians. The initial legislation designed to protect the public interest from the unlicensed and unlawful practice of dentistry by a corporate third party, without the knowledge or consent of patients, was largely stifled. A watered down bill was eventually signed by the governor.

Crony capitalism of the federal government’s support for big business dentistry is well established. The Federal Trade Commission (FTC) stated the aforementioned North Carolina consumer protection legislation for dental patients risked reduction in trade competition.7 The FTC blindly accepted arguments of the DSO industry at face value, while totally ignoring the federal Fifth Circuit Court of Appeals ruling 07-30430.
 
The FTC followed the same course of crony capitalism in support of the DSO industry in Texas.8 Absurd spin generated by the DSO industry became talking points of the FTC in an advisory letter to the Texas State Board of Dental Examiners’ legal counsel, “Proposed 22 TEX. ADMIN. CODE § 108.74 would make dentists who own, maintain, or operate a dental practice that employs a dentist “responsible for all administrative and operational” functions. Although the proposed rules do not expressly refer to Dental Service Organizations (“DSOs”), the rules seem likely to discourage dentists from affiliating with DSOs by mandating that dentists assume responsibility for the types of functions that DSOs typically provide, and by expanding the Board’s authority to take disciplinary action against dentists who enter into such prohibited agreements.”

The entire position of the FTC is based on a false premise of the doctor owning the dental practice and in full control of clinical decisions. Federal Fifth Circuit Court of Appeals ruling 07-30430, which is largely based on Texas state law, demonstrated the ridiculousness of that assumption. Dentists are employees, and are only nominee owners at best. They generally take orders from unlicensed managers. They can’t sell “their” asset of the dental practice without authority of the controlling party (beneficial owner), the DSO. Fee splitting of the doctor’s production billings are awarded to the DSO and are standard fare. Bonuses and quotas for clinical production are commonplace. Doctors retained for employment by a DSO rarely if ever have control over selection of clinical supplies or laboratories, in a patient’s best interest. Auxiliary clinical staff like hygienists and dental assistants is truly not under the direct control doctors, and too often freely engaged in unlicensed activities sanctioned by their employer, the DSO. Often the DSO, not the doctor, mandates which clinical specialists a doctor must give patient referrals to. Obviously, the DSO is intimately involved in the unlicensed and unlawful practice of dentistry. It’s in the interest of the DSO industry and the private equity investment industry to subvert government oversight and regulation, which they’ve been very successful in doing.

A master at the political and big business game of “pay to play” was former New Mexico Governor “Dollar” Bill Richardson (D-NM). His foray into the dental industry was through the New Mexico State Investment Counsel (SIC), which he chaired. The SIC was established to award low interest loans and grants, to New Mexico based businesses, in an effort to grow the state’s economy. $550,000 of state taxpayer money went to Small Smiles Dental (operated under the DSO title Forba). Forba was not headquartered in New Mexico, but Nashville, TN. Further at that time, the principle owner was Arcapita Bank (a today defunct Islamic Sharia compliant investment bank), in the Arabic Kingdom of Bahrain. To date, those taxpayer funds have never been accounted for.9
 

Nationally, numbers of DSOs have gone bankrupt, locked their doors to staff and patients, and abandoned patients in mid-treatment with citizen/patient funds on account. Examples include smaller DSOs in Texas10, but also larger corporate interstate chain dental clinics such as All Care Dental and Dentures.11 Prior warnings to government from concerned dentists did little to motivate state governments unwilling to take regulatory preventive action. State and federal authorities seem mired in the fantasy myth of doctors, and not corporate managers, as controlling corporate dentistry. With enough corporate money, reality gets distorted and government puppets dance to the tune, which they’ve been hired and paid for.


Blowback against Crony Capitalism in Dental Healthcare
 
Most states have statutes against fee splitting in healthcare professions, as it’s considered a highly unethical practice, and not in the interest of patients.12 (Author’s note: A doctor and most healthcare professionals have an ethical and fiduciary responsibility to place patient interests to the fore, because of their vastly superior expert knowledge and training.13 By contrast, a corporation has a primary ethical and fiduciary responsibility to generate profits for shareholders.14 The conflict-of-interest is self-evident. Neither doctors nor free market corporate managers can serve two masters. Healthcare isn’t the buying and selling of widgets.)
The North Carolina State Board of Dental Examiners (NCSBDE) filed suit against Dental One (a/k/a Dental Works), an interstate DSO, alleging the unlicensed and unlawful practice of dentistry by a non-dentist entity.15-6 This action filed by the NCSBDE has today been settled. Dental One has severe restrictions for alleged unlawful practice of dentistry, but only in North Carolina.

Washington State’s Department of Financial Institutions examined the dental franchise operation of Comfort Dental (chain of alleged dental franchises) and viewed them to be in violation of open disclosure laws of Washington, which largely mirror federal statutes.17A cease and desist order was agreed upon in the consent order of April, 2012. Yet, Comfort Dental continues to market so-called franchise opportunities in OH, IN, KY, MO, NE, KS, OK, TX, CO, NM, AZ, MT, as well as Washington, as of the date of this article.18 Seemingly, the cease and desist order within the consent agreement represents a meaningless “speedbump”, to the operation of Comfort Dental and its principles; Rick Kushner, Neil Norton and Graig Bears.
The Washington State insurance commissioner issued in August of 2015, a cease and desist order against the aforementioned Comfort Dental.19 This time the alleged violation was over the company’s “Gold Plan”. This is a discounted fee plan, which very closely resembles a duly registered and bonafide insurance vehicle, which it is not. Dentist franchise operators have expressed concerns in their individual states over potential misrepresentation to the public of Gold Plan as an insurance offering, specifically in MO, KY, and IN.20Unfortunately, franchise dentists are contractually obligated to honor Gold Plan regardless of possible violation to state law. Doctors are squeezed “between a rock and a hard place”.

More recently (February 1, 2016), the Hearing Unit Office of the Washington State Insurance Commissioner issued another cease and desist order against Comfort Dental Gold Plan, LLC.21 This order was required, as the previous order was allegedly disregarded by Comfort Dental. The insurance commissioner’s final order is well supported in detailed case law. The fines against Comfort Dental for non-compliance with the law are serious. Yet, one wonders if a few dollars placed in the “right” politician’s hand might not reverse this order? We’ll see.

One big complaint nationally by dentists working for Comfort Dental is their contract requirement to strictly use Budget Dental Lab for their patients. Serious concerns over dubious lab quality and negative patient outcomes have been expressed.20This problem isn’t restricted to Comfort Dental, but is a highly universal issue within the DSO industry negatively affecting patient care involving corporate unlicensed practice of dentistry.

Washington State hit Comfort Dental with yet another cease and desist order (July 5, 2016) for unlawful fee splitting via a “royalty” fee based on gross clinic collections, as well as the illegal practice of dentistry by a corporate entity.22 This action by Washington in many ways mirrors the earlier case by the NCSBDE against Dental One. The state’s brief is well structured, and again well supported in case law precedence.

One wonders how Comfort Dental and their directors; Rick Kushner, Neil Norton and Graig Bears will respond? Interestingly in the manner of organized crime Mafia figures, Rick Kushner (no longer a licensed dentist), is referenced as “the Godfather” on Facebook and by colleagues. One ponders how the DSO industry can continue the absurd myth, of not actively engaging in the unlicensed and unlawful practice of dentistry? How many palms need to be greased?


Corporate Dentistry Fights Back
The case was clearly made how corporate dentistry fought for their interests, over public interests, in North Carolina. That battle has been waged by the DSO industry nationally and on many fronts.23 Through media outlets and state and national legislatures, corporate dentistry has pounded home their self-serving messages. Money can purchase political favors, buy media attention, and even buy-off the dental profession itself (as the author will demonstrate later).
However, few in corporate dentistry have been so ham-fisted in squelching dissenting opinion, as Comfort Dental. Comfort Dental filed defamation suits again four individual University of Colorado dental professors, for alleged remarks made to students.24 That case has since been settled and parties aren’t talking, because of non-disclosure agreements in the settlements. Regardless, Comfort Dental has established corporate dentistry precedence, for shutting down opposition voices. The alleged slander was no worse than can routinely be found in online patient reviews of Comfort Dental, or most DSOs.

The DSO industry is currently fighting hard in Washington State, to put forth their misrepresentations, in spite of the disturbing activities of Comfort Dental and many others.25 Hired advocates place DSO myths and distortions in business publications such as Forbes.26 Money buys access, influence, and usually results.

Thursday, August 25, 2016

WHISTLEBLOWERS IN ACTION: Dr. Steven Pesis Discusses How Unethical Use of HIPAA Contribed to Patient Abuse at University of Pennsylvania

Dr. Michael Davis
Dr. Michael W. Davis maintains a general dental practice in Santa Fe, NM. He serves as chairperson for Santa Fe District Dental Society Peer-Review. Dr. Davis also provides a fair amount of dental expert legal work for attorneys. He may be contacted via email: MWDavisDDS@comcast.net
By: Michael W. Davis, DDS




image
Dr. Steven S Pesis DDS
Email: Shimstock1@gmail.com
Dr. Steven S. Pesis studied psychology at Queens College before receiving his DDS at The University of Michigan School of Dentistry. He then received advanced training in general dentistry by attending the AEGD residency program at the Kornberg School of Dentistry at Temple University. During his residency he was educated in a variety of complex dental cases, including full mouth rehabilitations, implant dentistry, esthetic dentistry, Invisalign and dental anxiety. Following his residency, he worked in public health dentistry until he joined the Penn Dental Family Practice at the University of Pennsylvania. He also taught as Clinical Associate in the Department of Preventive and Restorative Sciences for the University of Pennsylvania School of Dental Medicine.
 
Born and raised outside of Detroit, Michigan, Dr. Pesis is a member of a family of dentists. His father and uncle share a practice in Michigan, while his brother practices in the public health sector for Philadelphia. He hopes to use his knowledge of dentistry and psychology to provide patients with the best possible care, educate future dentists and to further the advancements in the dental field.
 

INTRODUCTION

Dr. Steven Pesis is a public safety whistleblower, who acted in accord with his ethical and legal obligations to expose patient abuses under the American Dental Association Principles and Code, Pennsylvania Commonwealth administrative statutes under the dental practice act, as well as internal policy of the University of Pennsylvania (U/Penn). As a result, Dr. Pesis alleges he was wrongfully terminated from employment by U/Penn. Dr. Pesis filed a legal action against the Trustees of U/Penn and Peter K. Kauderwood, assistant dean at U/Penn School of Dental Medicine.

See: Suit Claims Penn Dentist Was Fired For Reporting Unneeded Treatment
 
INTERVIEW
Dr. Davis: Dr. Pesis, I sincerely thank you for taking the time and effort to address matters of this case. Our readers will fully appreciate you are unable to address certain specifics and details of this issue, because of ongoing litigation. However, could you give our readers an overview and outline of your case? 
 


Dr. Pesis:Thank you for taking the time to discuss these issues, Dr. Davis. You are a true dental professional, constantly advocating for patients and bringing these issues to the public. The importance of quality care for dental patients, honesty and integrity are the cornerstones of dentistry and should not be overlooked.
 
My situation began close to a year ago. The Penn Dental Faculty Practice also known as the Penn Dental Family Practice (PDFP) renovated a large portion of a new building at the University of Pennsylvania in order to relocate one of its three offices. The cost quickly began to increase and once completed, the project was rumored to be severely over budget. This office at 3737 Market, known as the University City location, was to be the crown jewel of the PDFP and many of the top producing dentists were transplanted from the other offices to this new location. After all of the commotion, I remained as the only full-time dentist at the PDFP Locust Walk location and I was designated by Dean Denis Kinane of the dental school as the Clinical Advisor for this location.
 
Shortly after the opening of the new office, the Locust Walk location hired a new dentist in order to fill the void left by the relocation of multiple dentists. During the new doctor’s first few days working at Locust Walk, I received reports from doctors and hygienists that he was extremely aggressive in his treatment plans, over-treating patients as well as billing incorrectly. The clinical advisor from another office also discussed similar concerns with me regarding the new dentist. We both investigated the information and determined that there were real concerns regarding the new dentist’s billing practices and treatments of patients. These findings were finally reported to the clinical director, Dr. Alisa Kauffman. Shortly after the reports were made, I was terminated from employment from the University of Pennsylvania. I was pulled into an office and told that I had violated HIPAA and that I was being terminated from my clinical and teaching positions. I spent nearly an hour explaining that these allegations were false and that everything I did followed HIPAA protocol and did not violate the university privacy policy. One of the last things I said was that regardless of what my fate is, PDFP owes it to the patients to investigate the new doctor’s practices. To my knowledge, no investigation was conducted into the claims that were made and to this day, individuals at the PDFP remain scared to report any wrongdoing by the new dentist for fear of retaliation.

Tuesday, August 09, 2016

When Dental Surgery Lands A Patient in a World of Everlasting Regret

Houston Press logoDon’t miss this entire in-depth article by Dianna Wray at the Houston Press by clicking here.

“…Before Hoover went to work on Noah’s mouth, the receptionist told Deel it would cost $300.”

“…A few minutes later, Hoover asks Deel to come take a look inside Noah’s mouth. As Deel stands by, Hoover opens Noah’s mouth and begins poking around with her fingers and silver instruments. The cavity is too deep, she tells Deel. They might have to put a crown on it. Hoover gestures to the teeth on either side. These teeth are weak too, she says, so they need crowns as well.”

“…Deel agrees the teeth need to be fixed and goes back to the front, where McGonagle, who also happens to be Hoover’s husband, offers Deel another margarita. A dental hygienist appears in the waiting room and informs Deel his son now needs five crowns. It will cost $6,000 out-of-pocket, she says.”

“…McGonagle doesn’t miss a beat. He can see Deel is a nice guy and he wants Noah to get what the boy needs, McGonagle says. Deel might qualify for a “special loan” from a lender that pays the office “right then and there,” says McGonagle. “I’ve had good luck with these guys,” McGonagle tells Deel. Hoover’s office also bills the Deels’ insurance for $6,000. Before Deel has even thought about it, he has applied for a “care card,” a health-care credit card with an extremely low initial interest rate that soars if the card isn’t paid off within the first six months.”

“…According to state district court records filed in Galveston County, Columbo stated that “every one of the crowns done just months ago have short margins or recurrent decay under them.” The documents also allege that “Columbo [told] Lisa and Noah that the crowns need to be replaced in the next few months and furthermore that there [wasn’t] any indication that Noah needed five to six crowns. Columbo also [gave] Lisa contact information for the Texas State Board of Dental Examiners and [encouraged] her to file a complaint.”

“…The Deels contacted Jim Moriarty, a Houston lawyer with years of experience in dental cases, and decided to sue. The case was filed on August 2 in Galveston County District Court.”

“…Moriarty has been representing people and their claims against dentists and dental corporations for about a half-dozen years. “It’s mainly about trust. We’re taught to trust these people in white coats and to believe what they tell us, so it gets very hard for people to ask if they’re trustworthy,” Moriarty says. “

“…Insurance companies have also helped shape dentistry because insurance adjusters have kept the annual coverage rate cap between $1,000 and $1,500 since the 1970s, without adjusting for inflation, according to the American Dental Association. “There are so many financial pressures on dentists today. It’s getting much harder to make a profit than it used to be,” James Quiggle, spokesman for the Coalition Against Insurance Fraud, says.”

“…Another Houston-area case — one that has become infamous — involved four-year-old Nevaeh Hall’s trip to the dentist. When Nevaeh went to Dr. Bethaniel Jefferson’s dental office in January 2016, she was giddy with excitement, her mother says. On a previous visit, she’d taken home a backpack full of dental care supplies, and she loved brushing her teeth with her SpongeBob SquarePants toothbrush. On this second visit, as her dental records show, the plan was to extract her damaged baby front teeth — she’d fallen down face first shortly after the teeth came in — and put crowns on the teeth on the right side of her mouth. “

“…according to a report from the Texas State Board of Dental Examiners. She was given “large doses of anesthetic and sedatives,” and there were “warning sounds and visual indications which showed that for a period of five hours Nevaeh’s brain suffered from a severe lack of oxygen.”

“…When Amanda Lightfoot got the bill for her dental work, she burst into tears right there in Hoover’s waiting room. It was fall 2014 and Lightfoot had come in just to get two crowns replaced….She went home with a hole in her mouth where the tooth had been, and says Hoover told her it would cost about $20,000 to finish the work. Lightfoot cried all night. “

“…This is how most of these cases go, Moriarty says. Dentists are regulated primarily by the state dental boards, the entities that have the power to investigate and discipline a dentist who has done wrong. Unless a board decides to reprimand a dentist publicly, the odds are good the public will never know there has even potentially been an issue, he says.”

“…“People assume dental boards are out there to protect the public and to make sure the dentist that comes out of school can treat you. People assume these boards will be there to protect you from any unscrupulous behavior in the industry, but that’s just not the case,” says Debbie Hagan, a Kentucky homemaker and grandmother turned dental patient rights activist who writes a blog detailing various issues with dentistry across the country. “

“… In March 2016, 14-month-old Daisy Lynn Torres was at Austin Children’s Dentistry to have two cavities filled. Shortly after Daisy was put under anesthesia, Dr. Michael Melanson told Daisy’s mother, Betty Squier, the child needed six cavities filled. Soon afterward, Squier was told there were problems during the procedure. Daisy was declared dead at a nearby hospital about two hours later…In July, Robert Williams, a forensic dental examiner, stated in a report commissioned by the Travis County Medical Examiner’s Office and first obtained by KXAN TV that Daisy may not have needed any of the dental work in the first place.”

“…For people like Moriarty and Hagan, the fight against bad dentistry is in many ways a personal battle, one that evokes longstanding memories.

“…As a child, Moriarty had cavities eating away his two front teeth and his family never had the money to fix them. “I often wonder how my life would have been different if I’d been able to get to a dentist,” he says. “I remember going to high school and being so embarrassed. I feel like it might have been a very different life for me.”

“…“I wouldn’t smile in the class pictures, because of all the metal. Standing up in front of the class was torture because I knew they saw me flashing a mouth full of silver every word I spoke,” Hagan says. “I don’t think most people realize how important it is, that you have to have your teeth in working order in order to thrive. You don’t want to be different, especially when you’re young and going to school. It changes kids. It changed me.”

 

http://www.houstonpress.com/news/when-dental-surgery-lands-a-patient-in-a-world-of-everlasting-regret-8647456

Related Documents:

Wednesday, August 03, 2016

Economic Turf Wars over Dental Sedation and Public Safety

Dr. Michael Davis
Dr. Michael W. Davis maintains a general dental practice in Santa Fe, NM. He serves as chairperson for Santa Fe District Dental Society Peer-Review. Dr. Davis also provides a fair amount of dental expert legal work for attorneys. He may be contacted via email: MWDavisDDS@comcast.net
Economic Turf Wars over Dental Sedation and Public Safety
By: Michael W. Davis, DDS


Introduction
One can’t evaluate the different parties fighting over dental sedation privileges and the vast sums of money involved, without examination in the context of our toxic dental Medicaid program. Medicaid is a social safety net program jointly funded by the federal government and each individual state. However, administration of dental Medicaid is left to the particular state. Each state handles dental Medicaid very different with a complex variety of outcomes.

Florida
For example, the state of Florida refuses to authorize hospital-based sedation for dental Medicaid cases. Therefore, many of the most severe dental cases go untreated. Institutionalized patients for severe developmental disorders often go untreated. The potentials for ensuing major medical problems may go unaddressed, until the crisis stage for morbidity and mortality (illness and death).
As a result, numbers of Florida dental Medicaid providers deliver in-office sedation upon patients, who truly should only be seen in a hospital setting. Children, who have a much greater compromised airway than adults, are treated en masse with cocktails of different sedation medications, and in risky dose levels. In order to maximize dollar production under a flawed Medicaid fee schedule, these doctors are notorious for a dangerous lack of patient monitoring.

 https://appsmqa.doh.state.fl.us/DocServiceMngr/displayDocument.aspx
 
Authorities rarely deliver more than wrist-slap regulation upon these violators, as their removal from the Medicaid system could hasten the collapse of this broken government program. The poor and disadvantaged are left between a rock and a hard place. They can elect to eat a $hit sandwich or go hungry.

Other providers of Florida dental Medicaid pursue a different scheme. They simply place any “uncooperative” child in restraints (euphemistically called “protective stabilization”). Again because the dental Medicaid fee schedule is so abysmal, these doctors feel justified in maximization of dollar production regardless of a child’s stamina, understandings, and limited abilities. All treatment possible is completed in a single visit. In order not to overdose a child for local anesthesia (generically termed “Novocain”) for their diminutive body weight, these doctors frequently deliver inadequate anesthetic, which generates excruciating patient pain. However, with the child adequately restrained, dental services of extractions, steel crowns and pulpotomies (baby root canals) continue, regardless of a child’s discomfort. Obviously, many of these patients will be in need of extensive psychological counseling for posttraumatic stress. Unfortunately under our programs for the disadvantaged, it’s doubtful this brutal problem of which government bares great responsibility, will ever be addressed. Medicaid dentists too often choose between “juice ‘em (sedate) or papoose ’em (physical restraints)”.

https://appsmqa.doh.state.fl.us/DocServiceMngr/displayDocument.aspx
http://floridajustice.com/wp-content/uploads/2015/11/Schneider-arrest-warrant-affidavit.pdf
https://appsmqa.doh.state.fl.us/DocServiceMngr/displayDocument.aspx
 
Whistleblowers who step forward in Florida to expose these abuses to authorities are met with institutional roadblocks. These professionals with integrity are forced out of government service by superiors. The rationale is that if the crooks and abusers are severely disciplined and removed as Medicaid dental providers, there will be too few providers to keep the toxic program viable. Government enables the abuse of our most vulnerable citizens and assists in cheating taxpayers. http://media.news4jax.com/document_dev/2016/02/03/Dr.%20Mason_2048400_ver1.0.pdf
 
New Mexico
New Mexico (NM) allows for dental Medicaid hospitalization and sedation coverage, unlike Florida. On paper and in theory, Medicaid patients will be permitted access to hospital operating rooms and nurse anesthetists for necessary dental care. The reality is quite different. Further, the in-fighting between providers and hospitals is in anything but in the interests of patients.

Monday, August 01, 2016

Washington State Issues Notice on Comfort Dental

Washington state plans to enforce it’s laws against corporations practicing dentistry. Can we stand up and give Washington a round of applause, please.

Washington State Notice of Intent against Comfort Dental for illegal practice of dentistry

Wednesday, July 27, 2016

Dental Insurance Rip-Offs… Consumers Beware!

 
imageDr. Michael W. Davis maintains a general dental practice in Santa Fe, NM. He serves as chairperson for Santa Fe District Dental Society Peer-Review. Dr. Davis also provides a fair amount of dental expert legal work for attorneys. He may be contacted via email: MWDavisDDS@comcast.net


 
  Dental Insurance Rip-Offs… Consumers Beware!

One of the biggest scams facing dental consumers are products sold to them, which are misrepresented or falsely presented as dental insurance. The reality is usually quite different. Other times the product sold to the public is truly dental insurance, but it has virtually no value or entirely no value to the consumer. The bait presented to the potential dental patient is low- cost monthly payments for insurance. Unfortunately in too many cases, the dental consumer is hustled out of their money with little or nothing to show in cost savings or benefits.

Bogus Dental Insurance Plans
 
There are swindlers who sell consumers all sorts of insurance plans for low-cost monthly payments. Sadly, the plan administrators failed to secure the services of any healthcare providers, assuming these bogus insurance plans even have an administrator. All legitimate dental insurance programs must be registered within the states they do business within. They must comply with each state’s rules and regulations for dental insurance. A check with your state insurance commission will provide you with a listing of all duly and lawfully registered insurance providers. If the dental insurance company providing the plan isn’t listed, that’s a red flag warning. Stay far clear of that company.

Discount Programs
 
Discount programs for dental services are too often presented in a deceptive format, which gives the impression of dental insurance. For that reason, numbers of states have outlawed these discount plans. In no case are these dental discount plans regulated by the state insurance commission. However, numbers of state attorney generals have attempted to close down these dental discount card programs, in service of the public interest.

Some discount dental programs are sold by independent companies, with little or no background history available. They may or may not even have enrolled dentists, who participate and honor their discount cards. Too often, the few dental clinics which do accept these discount programs artificially inflate their fees, to offset any consumer savings. Other dental clinics find these discount plans work to get customers in the door, for more profitable bait-and-switch scams or hard-sell upselling of additional services. Unfortunately, consumers attracted to purchase these discount cards are frequently financially disadvantaged, and not particularly sophisticated in dishonest business dealings. They are primed for the plucking.
Large corporate dental clinics also sell dental consumers a variety of discount dental plans, which are administered under their company. Again, numbers of states have outlawed these plans, because they too closely resemble lawful insurance programs, which they are definitely not. Some corporate dental outfits manipulate and misrepresent their fees in a variety of ways, such that patients purchasing a discount plan actually may have no cost savings, or actually pay more, than patients utilizing standard dental insurance.

Sales of dental discount plans have become so lucrative, that bonafide dental insurance companies have entered into this racket. It’s highly profitable for them, as they don’t need to register these plans as insurance vehicles with any state regulatory commission, and they aren’t as subject to state or federal auditing. Moreover, these discount plans cost the insurance company no outlay of expenditures for patient dental benefits. Since there is no remuneration paid to dental providers by the insurance company (only a promise by dental clinics to discount fees), the insurance company has little incentive to monitor or audit billings from dental providers. Unfortunately, too often the same bait-and-switch and hard-sell upselling we see with corporate dental clinics, also happens with dental clinics accepting dental discount cards sold by an insurance company. Once again, consumers get screwed.

Dishonest Dental Insurance
Dishonest dental insurance has become a highly popular swindle, especially since the inception of the Affordable Care Act (ACA) and the various state insurance exchanges. Yes, these are genuine dental insurance programs, many of which are specifically designed to cheat consumers. With all the new changes in the insurance industry, many state regulators are ill-equipped to provide appropriate oversight. In this deceitful quagmire of the insurance industry, consumers are at risk. Let’s examine some of the more popular methods of gaming dental patients.

Numbers of health insurance companies today sell dental insurance at an additional upgrade fee. What often isn’t disclosed to the plan purchaser is that the dental coverage is fully embedded in the medical insurance plan. The consumer is sold on dental insurance, which covers preventive dental services, along with many restorative services. What isn’t disclosed is that the consumer often must reach the medical deductible limit of $5-6,000, before they become eligible for dental benefits.

Saturday, July 23, 2016

Association of Dental Support Organizations Tax Return Comparison 2007 thru 2013

Association of Dental Support Organizations Tax Return Comparison 2007 thru 2013

Nashville Based Marquee Dental Partners: Just Another DSO

Am I the only one to notice that every Dental Support Organization (DSO) markets themselves as the grand poohbah of the DSO industry? Marquee Dental Partners, who launched in October 2015 with a $35 Million investment from Chicago Pacific Founders, says they are the premiere of DSO’s. 

Let’s look at this up-and-coming DSO.

According to their website, they now own 19 practices in the Southeast. The headline reads, “Marquee Dental Partners Acquires Bryant Dental, Expands to 19 Practices in Southeast “.

By “acquire” I assume the 19 practices were not given to them, right? Must have bought them, right? So now they own them, right?

July 2016: Bryant Dental – 3 Locations - Alabama - Founder - W. Forrest Bryant, DMD
May 2016: Save-On Dental – 5 Locations - Alabama - Co-founder Dr. John Denton
May 2016: Signature Smile – 2 Locations - Alabama - Dr. L. Don Wilson and Dr. Kristen Bentley
January 2016: Winfree and Denton Cosmetic and General Dentistry – 1 Location - Hermitage, TN - Dr. Terry  Winfree, DDS, and Dr. Greg Denton, DDS
December 2015: Bohle Family Dentistry – 1 Location - Paducah, KY- Dr. Chip Bohle, DMD
October 2015: Embassy Dental – 7 Location - Nashville, TN - Founder Dr. Warren Melamed

With each “acquisition” Marquee Dental Partners releases a statement that claims:

“...to have entered into an affiliation agreement”
“…provide dentists with both support and clinical autonomy they need”
“…seamless transition”
“…acquired the business end of [clinic]
(fill in the blank founder/dentist) will continue to either be actively involved or continue to provide high quality care for patients.

Checking the Tennessee Secretary of State Website I found the following:

Marquee Dental Partners, LLC , a Delaware company, entity filing date 2/12/2015

Name: CPF Dental, LLC (Chicago Pacific Founders Dental, LLC)
Formed in: Delaware
Original Address: 23 Northumberland, Nashville, TN 37215 (home of James Usdan and Lisa Butlak)
Principal Office Changed on April 2016 Annual Report to: 2025 21st Ave, Ste 204, Nashville, TN 37212
Number of members: 1 (likely James Usdan)
Assumed names: Embassy Dental and Marquee Dental Partners
Consent Given to Name Change from” No value To: TN Dental Professionals, PC

TN Dental Professionals, PC has assumed names listed as:

Winfree & Denton
Winfree and Denton Cosmetic and General Dentistry
Embassy Dental
Marquee Dental Partners

There is also a TN Dental Professionals, II PC started February 1, 2016. No assumed names, yet. Registered Agent is Donald R. Moody, 511 Union St. Ste 2700, Nashville, TN 37219-1791.

From Marquee Dental Partner Website:

Marquee Dental Partners Launches with $35 Million in Funding to Support Dental Practices

October 13, 2015

Nashville, TN – October 13, 2015 – – For many dental practices in today’s market, the pressures of performing administrative and billing functions prevent them from focusing their attention where it’s most needed: their patients. Launched with a $35 million capital commitment from Chicago Pacific Founders, Marquee Dental Partners provides dentists with both the support and the clinical autonomy they need to succeed.

Friday, July 22, 2016

Daisy Lynn Torres’ Needless Death Raises Questions

In March, Daisy Lynn Torres’ parents took her to Austin Children’s Dentistry in Austin, Texas to have stainless steel crowns placed on two teeth. After the dentist got his hands on Daisy, he suddenly found she needed a total of 6 crowns. This is the classic bait and switch dentistry I hear so often which sadly has become the norm.

During the procedure something went terribly wrong and baby Daisy went into cardiac arrest. 911 was dispatched and Daisy was taken to the hospital where she was later pronounced dead. According to the heart wrenching story in People Magazine, Daisy’s mother, says her daughter was “dead before she even left the dentist office”.

Fast forward to July 15, 2016, NBC affiliate KXAN in Austin published a story suggesting Daisy Lynn, didn’t need the procedure. Not exactly a shocker. 

“One can only speculate as to why any treatment was performed considering no indication of dental disease or pathology was seen in the dental radiographs (x-rays) in the dental visit dated 03/29/2016,” writes Robert Williams, a forensic odontologist. While the initial x-rays prior to work being done showed no disease, the report does note that x-rays taken after the child’s death indicated four teeth appear to have dental work performed on them. According to the report, the child’s teeth had been prepared to have stainless steel crowns placed on them.

“It is possible that the partially erupted teeth may have had a congenital enamel defects but not necessarily requiring treatment with a child of this age,” the report notes. “No evidence that the child was in any type of pain was ever notated in the dental record and no pulp vitality test was ever performed.”

According to KXAN, the initial report from the Travis County Medical Examiner mentioned a difference of opinion between Dr. Michael Melanson and the forensic odontologist, and it wasn’t until the station requested the entire report was it revealed just exactly how much those opinions differed.

The report also states Austin Children’s Dentistry has suspended Dr. Michael Melanson. However, I find no evidence of the any disciplinary actions taken by the TSBDE. In fact, as of July 22, 2016 Dr. Michael P. Melanson’s dental license shows no Disciplinary Actions whatsoever.

160722 Michael Melanson dental lic-clean

Of course Austin’s Children’s Dentistry says of course no evidence was found that the child needed the procedures, it had been removed; the standard boilerplate statement. 

“The report reveals no surprises to us. By the time the forensic odontologist evaluated Daisy, all evidence of dental disease had already been removed by the dentist, as expected. A treating dentist always has the advantage of pre-treatment visual exams, clinical findings, and x-rays on the patient; as well as knowing the patient’s dental history, unlike a forensic odontologist. The treating dentist in Daisy’s case will present all of the evidence that justified Daisy’s treatment if called on to do so.”

Well, I’m certainly waiting for Austin Children’s Dentistry and Dr. Michael Melanson to be “called on to do so”.

Just two months prior to Daisy Lynn’s death, 4 year old Navaeh Hall had gone to Diamond Dentistry in Houston where Dr. Bethaniel Jefferson's treatment left Navaeh severely brain damaged. The Texas State Board of Dental Examiners placed Dr. Bethaniel Jefferson’s license on temporary suspension. “In essence what happened is this child was chemically and physically suffocated,” stated Jim Moriarty, the attorney reprsenting Navaeh Hall and her family. Was this also what happenedd to Daisy Lynn Torres?

Here are my questions:

1. Was little Daisy and these parents victims of Bait and Switch Dentistry at Austin Children’s Dentistry? I believe they were.

2. Who owns Austin Children’s Dentistry? There is substantial evidence to suggest it is owned and operated by Tal Shohomy, a Wall Street trader, who also owns/operates White Angel Veterinarian Clinic. where his wife is a veterinarian.

Tal Shohamy Bio from White Angel Verterinarian Clinic:

Tal Shohamy Bio

3. Was Dr. Melanson being pressured to overtreat in order to bilk Medicaid/Insurance? We know it is common these days to “milk the cow dry” as it was so eloquently stated by Small Smiles dentists.

4. Where was this anesthesiologist who was supposedly monitoring Daisy? Chatter in the dental community suggests he wasn’t even in the room with Daisy.

5. Is anyone suing this dentist, owners and clinic? If not, why the hell not!

6. Has a complaint been filed with the Texas State Board of Dental Examiners? I would hope so!

Wednesday, June 29, 2016

American Dental Association’s Strange Bedfellow, Wonderbox Technologies

Dr. Michael DavisDr. Michael W. Davis maintains a general dental practice in Santa Fe, NM. He serves as chairperson for Santa Fe District Dental Society Peer-Review. Dr. Davis also provides a fair amount of dental expert legal work for attorneys. He may be contacted via email: MWDavisDDS@comcast.net
 



American Dental Association’s Strange Bedfellow, Wonderbox Technologies
On June 8, 2016, the American Dental Association (ADA) announced its collaboration with Wonderbox Technologies.1 The effort is designed to provide a centralized computerized credentialing service for doctors, at no cost to ADA member dentists. This database could be accessed by third party payers such as insurance companies, government entities, hospitals and clinics, as well as employers. The desired result is a more streamlined credentialing process with elimination of duplicative efforts.

Obviously, such a data bank will contain highly confidential material. The consequences of a data breach could easily compromise doctors, but also potentially damage entities legitimately attempting to access data for dentist credentialing. Personnel at Wonderbox Technologies and the ADA involved in safeguarding private information must maintain the highest levels of ethics and meticulous safety protocols.

Craig Kasten is the board chairman and co-founder of Wonderbox Technologies. Formerly, Kasten was co-founder and co-owner of Doral Dental, an interstate dental Medicaid administrator. Doral Dental was bought out by DentaQuest, in 2004 for a reported $108 million.
Craig Kasten and Doral Dental gained notoriety during the federal criminal trial of today convicted felon (66 months), John Ford on bribery scheme charges.2-4 Former Tennessee state senator, John Ford was commonly known as “Mister 10%”. This referenced his alleged unlawful skim on state government contracts.

John Ford(2)
Doral Dental paid through a consulting firm over $400,000 to John Ford, in order to secure an $18 million state contract to administer dental Medicaid in Tennessee. Prior to the payment, Senator Ford spoke vociferously against the services of Doral Dental in Tennessee. The astonishing turnaround was 180 degrees, once payment was assured.


During the trial of John Ford, the defense wanted to call upon the testimony of Craig Kasten. Kasten agreed, but only under the condition the government offered him immunity. The prosecution declined to offer immunity, and in turn, Kasten invoked his Fifth Amendment right against self-incrimination. US Assistant Attorney Eli Richardson stated about not offering Craig Kasten immunity, “(He) is not a candid witness; he is not a reliable witness.”

In short order after acquisition of Doral Dental by DentaQuest, DentalQuest dismissed all senior management formerly associated with Doral. On March 23, 2005, Doral Dental (acquired by DentaQuest prior year) released an internal investigation which pointed the finger at Kasten and other former Doral executives for the deals with Sen. John Ford. Craig Kasten, nor any former director or management of Doral Dental, has ever been indicted for activities centering on the criminal bribery actions of John Ford.


John Ford
One is left to speculate on the vetting process employed by the ADA in selection of their corporate collaborators. The concept of a centralized database for doctor credentialing on its face seems highly constructive. This would benefit dentists, as well as those legitimate parties seeking data for the credentialing process. However, the integrity of those “guarding the henhouse” of a doctor’s personal and professional identity must be beyond reproach.
 
 
References
1. http://www.ada.org/en/publications/ada-news/2016-archive/june/ada-wonderbox-create-comprehensive-credentialing-website
2. http://www.iclassifiedsnetwork.com/contentitem/74145/1259/tenncare-contractors-were-slow-to-divulge-deals-with-ford
3. http://nashvillecitypaper.com/content/city-news/fords-attitude-toward-doral-dental-makes-180-degree-shift-testimony-shows
4.https://news.google.com/newspapers?nid=1683&dat=20050324&id=_70aAAAAIBAJ&sjid=dEUEAAAAIBAJ&pg=6300,3161534&hl=en
















Saturday, June 18, 2016

Brit Teen Review’s Sunny Malouf and “My House”

Sunny is the daughter of Richard Malouf, disgraced Texas dentist and former owner of All Smiles.  A couple of years ago he and his outlandish house built on taxpayers money were in the news often in Texas.  I guess he didn’t get enough coverage to feed that massive ego.

This is so funny I don’t even know what to say. 

Enjoy!

What I don’t understand is why the authorities in Texas never found this just as outrageous.

Didn’t he sue WFAA for taking aerial photos of his place a couple of years ago. Interesting.

Here is the link to her youtube channel where the video resides.  Don’t miss those comments. Also note the 278,000 views, with 2,545 LIKES and 15,834 DISLIKES.

https://www.youtube.com/watch?v=tFUVvCQWPqk

If anyone is looking for a place to live, the place is for sale for a mear $32,347,000.00.

.  Don’t miss all the pictures! It’s awesome.

http://www.briggsfreeman.com/search/property-details.asp?streetaddress=10711-Strait-LN-Dallas-75229&npg=1&Cg=SingleFamily&SN=10711%20Strait&source=qlist&pn=29076

Saturday, April 09, 2016

Is Florida paying dentists a “per patient” fee on top of reimbursement for services?

Is Florida paying dentists a “per patient” fee on top of reimbursement for services? It sure sounds that way in this sworn statement by Dr. Jodi Mason.  Dr. Mason was interviewed in connection with the Florida Medicaid Fraud Contol Unit’s investigation into Howard Schneider, DDS.  Her last statement was a bit more revealing that I suspect was expected as the interview concluded.  Personally, I think that is where the real questioning would have started if the goal was learning more about the widespread dental fraud in Florida.

This interview was posted by News 4 in Jacksonville and can be found here:

http://media.news4jax.com/document_dev/2016/02/03/Dr.%20Mason_2048400_ver1.0.pdf

State of Florida Office of Attorney General Medicaid Fraud Control Unit
Howard Schneider, DDS, Jacksonville, Floridia
OAG Number: MFC-15-00381
May 12, 2015 Interview of Dr. Jodi Mason by David Schwab
Dr. Mason worked at the Duval County Health Department from 2007-2008 and from 2009-2011, before opening her own practice.

Dr. Mason was asked by Schwab to tell him about working on patients after they had seen by Dr.
Schneider. Dr. Mason said that she spent the majority of her time that she was at the Health
Department working on patients that had been treated by Dr. Schneider. Any of the patients of the
Health Department that needed a pediatric dentist, which was a significant number of patients, were
either referred to either Dr. Schneider or Dr. Klein. Those patients would then return to the Health
Department for their care after their treatment needs were taken care of by Dr. Schneider or Dr. Klein (Dr. Klein passed away in 2008).

Schwab asked Dr. Mason what kind of issues the patients that had seen Dr. Schneider came back with.
Dr. Mason said "As best as I can recall. There were a lot of abscessed teeth that had been restored with
nerve treatments and a crown and the crown had come off. I mean, it was like if Dr. Schneider had
done crowns the crown was gone, if Dr. Schneider had done a filling the filling was gone. So, the teeth
that he had done fillings on they needed crowns or needed to be taken out, or the teeth that he had
fixed needed to be taken out, um, because they either had an infection and he fixed that, instead of
taking it out or, um, they got an infection after he fixed it. Um, so a lot of infections, um, so, yeah."
Schwab asked Dr. Mason if the crowns that she had to replace looked like they had been cemented on
or just forced on the tooth. Dr. Mason said "At the point I saw them the crowns were gone, there was
no crown there, usually we didn’t see a loose crown or anything it was, the crown was gone. Um, very
rare that the patient or parent actually brought the crown in you know, and if they did I don’t think that
I would’ve, I would remember, if there would have been cement inside of it or not, though."

Schneider pull quoteDr. Mason said that she has some patients at her practice now that were patients of Dr. Schneider, but she said it is a very low number. The patients that she does have that went to Dr. Schneider have the same issues as the issues the patients she saw when she was with the Health Department; as far as crowns being gone. Schwab asked if the patients that she sees from Dr. Schneider now at her practice are Medicaid. She is not a Medicaid provider and the Medicaid patients that she does see pay cash for the procedures that she performs. Dr. Mason said that she would work on putting together a list of Medicaid patients that she is treating at her practice.

Dr. Mason said that parents of patients that had been treated by Dr. Schneider told her about their child having scratches and bruises. Dr. Mason said that when she heard those types of stories she would encourage the parent to report the abuse. She said that she never saw any of the scratches or bruises by the time the child got to her. She also stated that even when she was at the Health Department she encouraged people if they didn’t think that the work was done properly or the child was abused to report it.

Schwab asked her if she ever used the papoose board. She said that she has used it twice in the last
year; she said that she usually will use it only for frenectomies (a procedure to cut a piece of skin
under the tongue, or lip, to allow more movement of the tongue or lip). Usually if they are under two,
or three years old, and the parents uncomfortable or unable to hold the child still enough to do certain
procedures which are short procedures she would use the papoose board. Dr. Mason also said that she
did use one a little more often when she was at the Health Department, but she only used it on cases
where there was an infected or broken tooth that had to come out. She said that she does not practice
like that and advised Schwab that she does not do conscious sedations at her office for safety reasons.

Schwab asked Dr. Mason if she was treating a patient that was "fighting” did she ever hold them down
by their throat. Dr. Mason said "No." Schwab then asked Dr. Mason have she ever held a patient
down by their throat, pinch their nose and put your hand over their mouth. Dr. Mason said "No. I
know that was a technique hand, hand over mouth was a technique that was used, somewhat used you
know, with a couple of generations ago dentists, you know back before they had gloves." Schwab
asked Dr. Mason about putting their hand in the child’s mouth so they could not breathe. Dr. Mason again said "No, I think that would be counter intuitive."

Dr. Mason said that if there are behavior issues that preclude doing procedures safely she has an
Anesthesiologist that comes in and can do I.V. sedation. It is expensive because the Anesthesiologist
set their fees and is usually out of network. She said that based upon her experience as being a Dental
Assistant, then working at the Pediatric Dental facility at the University of Florida, she has the ability
to determine if she is going to be able to get through to the end of the procedure safely.
Dr. Mason said unless it’s an emergency they don’t hold anyone or against their will. The parent is in
the room and either the parent will be holding the child or they would be right there. I would tell Mom
"I am going to hold her head and I need you to hold her arms." We would do that for a couple of
minutes and then we would take a break.

Schwab asked Dr. Mason if she thought that having the parent in the room with the child helps the
child stay calm. Dr. Mason replied sometimes it does, sometimes it doesn’t, but it depends on the type
of parent. She clarified saying that any time it gets to that point or if you have those behavior issues,
even if they are less calm with Mom in the room, she would still want Mom in the room to see what
was happening. That way if you hear screaming you know what is going on. Dr. Mason said that there
are some of her patients’ parents that do not want to be in the room, therefore, she lets the parent
decide.

Schwab asked Dr. Mason if the children that had been to Dr. Schneider showed more fear, and
anxiety, than children that had not been to Dr. Schneider. Dr. Mason said, "That part of it, it wasn’t
just fixing the work at the Health Department. It was working through or trying to work through all
those behavior and anxiety issues, you know, here, it’s a lot less of it. But, the children are truly afraid
and very, very scared, and it just takes a little more time to build that relationship, ok, we’re not going
to do anything that is scary here, um, and there are some of those we have been able to work through."

Dr. Mason then said, "This is part of the reason I left and it was because I kind of got tired of
censoring my words from parents because I didn’t want to bad mouth other people’s work." Dr.
Mason continued "It got back to my supervisor that I wasn’t happy with the care that people were
receiving there, and he made me have lunch with Dr. Schneider. He like set up a lunch so that I could
meet him and see what a nice man he was to provide this service for these children, and um, that was
the day I decided to leave, was after I had to have lunch with him."

June 13, 2016 is the date set for the fraud case against Dr. Howard Schneider of Jacksonville, Florida

April 4, 2016
JACKSONVILLE, Fla.
- A trial date has been set for embattled pediatric dentist Dr. Howard S. Schneider, who is facing 11 counts of Medicaid fraud.

Schneider, 78, pleaded not guilty to those charges and one count of scheme to defraud.

More Jacksonville Headlines

His lawyers argued unsuccessfully last month to have the charges dismissed.

Schneider's trial is set to begin June 13.

Schneider remains free on $110,000 bond and is now living in St. Simons Island, Georgia.

Read the entire story here.

Friday, April 01, 2016

14 Month Old Daisy Lynn Torres dies after visit to Austin Children’s Dentisry

Austin Children's DentistryAustin, Texas – 14 month old toddler, Daisy Lynn Torres, died March 29, 2016 after visiting Austin Children’s Dentistry in what spokesperson, Sarah Marshall, says was a “fairly routine” procedure that required anesthetics.

As pale and frightened as Marshall looked on camera, I suspect she was scared to death to actuall “speak”. Marshall also said, they have been in business for 40 years! Really? She also  told KVUE-TV “these types of procedures are done all the time”. Really?

I wonder if the routine part actually means that their office routinely sedates children unnecessarily for unnecessary procedures in order to bilk Medicaid or other insurance.  Let’s face it, we are talking Texas here, right?

According to Daisy’s mom—as reported in a follow-up report by KVUE-TV—Daisy was only supposed to have two cavities fixed, then about 15 minutes into the procedure, they came and told Daisy’s mom they were going to go ahead and do 6—4 stainless steel crowns on top, and 2 on the bottom.

Daisy’s mom told KVUE reporter Kris Betts, about 10 minutes later, the dentist returned saying Daisy was having a “difficult time”. After taking her mom back to see her, they assured her mom that she was fine. Shortly thereafter, an ambulance was called. The ambulance took Daisy to North Austin Medical Center. Her mother followed the ambulance to the hospital. Upon arriving she was told Daisy was already brain dead.

So what happened?

Wednesday, February 24, 2016

Are you a Pacific Dental “owner” or “employee”?

This is to all the poor souls who have found themselves in Pacific Dental Hell.

If you are associated with Pacific Dental and one of their many clinics and feel you are not getting your cut as promised by the company, I would love to hear from you.  If you are a member of the support staff and notice things that just don’t seem right, I.E. taking too many x-rays, over-treatment, etc., I would love to hear from you.

If you know of—or even suspect—fraud taking place in any clinics associated with Pacific Dental, remember Whistleblowers, get a piece of the pie so to speak when they file a Qui Tam lawsuit.

Be that as it may, I’m gathering information—that I will post later— where I will shed more light on the full scope of the scam and how they are screwing their “owner” dentists.

cckaddie@yahoo.com

Tuesday, February 23, 2016

A Fart By Any Other Name Still Stinks, Part 1

Obviously the condemed Small Smiles Dental Centers are still operating and expanding in South Carolina.

2016-02-19 16.56.22Small Smiles of Myrtle Beach is operating as Oceanside Dental-Kings Highway Dental Health Center, PC

Michael Alessi, DDS

Jeremy Bondurant, DDS

Edmond R. Proctor, Jr. DDS, MS

DANIEL SPEARS, DDS

 

 

 

 

 

 

 

 

 

2016-02-22 09.48.18

 

Small Smiles of Florence, SC is operating as Bright Start Dental-Irby Street Dental Health Center, PC

Desinta Speller, DDS

Stella Faria, DDS

Edmond R. Proctor, Jr. DDS, MS

Daniel Spears, DMD

 

 

 

 

 

 

 

 

2016-02-16 12.40.01

Small Smiles of Columbia, SC is operating as Capital City Dentistry-Two Notch Road Dental Health Center, PC

Me’Chell James DMD

Kristin L. Robertson, DDS

Edmund R. Proctor, DDS, MS

DANIEL SPEARS, DMD

 

 

 

 

 

 

 

 

 

2016-02-22 13.04.04

Small Smiles of Spartanburg, SC is operating as Sparkle City Dental – Whitney Road Dental Health Center, PC

Dianah V. Barable, DDS

Mary Johnston DMD

Anna Y Kamdar DMD

J. Lee Moor, DMD

DAN SPEARS, DMD

 

 

 

 

 

 

 

 

The former Small Smiles in Greenville, SC operates as under Pleasantburg Drive Health Center, PC. The North Charleston South Carolina Small Smiles operates under Rivers Avenue Dental Health Center, PC. All of the above listed Professional Corporations were registered on July 30, 2014 with Dan Spears as the Registered Agent.

Moving over to Georgia, Daniel Spears is still listed as an officer of the former Small Smiles of Savannah, GA which is now operating as Savahhah Smiles Youth Dentistry, PC. with the princial office as 4746 Wehunt Trail SE, Smyrna, GA. with Todd Bjur, DDS as CFO and CEO.

160101 Savahhan Smiles Youth Dentistry PC-dan spears-todd bjur-ga-sos

 

 

 

 

 

 

 

 

 

Two new PC’s were filed in January 2016 at the South Carolina Secretary of State: Wesmark Dental Health Center, PC in Sumter, SC and 45 Wesmark, LLC; the Registered Agent for both of these corporation is also Dan Spears.

Below is the record on Dr. Proctor at the South Carolina Dental Board.  He is not listed as having a licenses in North Carolina, but does appear in the College of Diplomats of the American Board Of Pediatric Dentistry.(ABPD), as does the former Chief Dental Officer of Small Smiles, Dr. Steven Adair. The ABPD should not be confused with the American Academy of Pediatric Dentistry (AAPD). Amazingly, Dr. Proctor was issued a South Carolina dental license just days prior to the creation of all the professional corporation registered to Dan Spears; 16 days to be exact.

Edmund R Proctor DDS

 

 

 

 

 

 

 

The address for Dr. Proctor in North Carolina, according to the ABPD website is 1056 Meadowlands Trl NW and although it can be found associated with “Clinton Children’s Dentistry” the address is that of a home, not a dental clinic, and Clinton is Clinton, New Jersey.

According to the New Jersey Dental Board website, Dr. Proctor was issued a dental licenses there in 1983 and at one time had a couple of clinics.

Edmund Proctor, Jr New Jersey dental lic

 

 

 

 

 

Getting back to Dr. Todd Bjur, DDS, a long time Small Smiles dentist—as is Daniel Spears—according to the Georgia Secretary of State website, Dr. Bjur and Dr. Terrence  VanDiver are officers in the other former Small Smiles clinics in Georgia, as is a company, Paranet Corporation Services, Inc.

Oh, and according to the 2016 annual reports, the prinicpal office address for the other Georgia clinics is 401 Church Street, Suite 2210, Nashville, TN 37219.

Youth Dentistry of Macon-Terrence Vandiver DDS-ga-sos

 

 

 

 

 

 

 

 

 

Clearly, folks in Nashville are still involved and the new corporation structure is meant to continue the confusion.

 

Related:

American Board of Pediatric Dentistry overview

Tuesday, February 09, 2016

Federal Court Decision on Dental Specialties- Interview with Frank R. Recker, DDS, JD

 

Dr. Michael DavisDr. Michael W. Davis maintains a general dental practice in Santa Fe, NM. He serves as chairperson for Santa Fe District Dental Society Peer-Review. Dr. Davis also provides a fair amount of dental expert legal work for attorneys. He may be contacted via email: MWDavisDDS@comcast.net

 

 

 

Frank R Recker, DDSDr. Recker began his career in general dentistry in Cincinnati, Ohio during which time he served as a member of the Ohio State Dental Board. When the laws prohibiting dental advertising were overturned in the early 1980’s, he was charged by the Board to rewrite Ohio’s advertising laws. In the 1980’s he left the clinical practice of dentistry and began a legal career consisting solely of dental issues, dental board defense, and the First Amendment Right of dentists. Since that time, he has appeared before over 50% of the dental boards in the country representing dentists, and has litigated every case, in state or federal courts, involving dental advertising.

Dr. Recker is a Life Member of the American Dental Association (ADA), the American Association of Dental Boards (AADB), a Fellow of the American College of Dentists (ACD), a Fellow of the American College of Legal Medicine (ACLM) and a member of multiple state and local dental societies. He is licensed to practice dentistry in Ohio and Florida, and admitted to the Bars of Ohio, Kentucky and Florida, as well as multiple federal courts throughout the country, including the United States Supreme Court.

 

INTRODUCTION

Dr. Frank R. Recker was the lead attorney representing plaintiffs American Society of Dentist Anesthesiologists (ASDA), American Academy of Implant Dentistry (AAID), American Academy of Oral Medicine (AAOM), and the American Academy of Orofacial Pain (AAOP) in the recent case against the Texas State Board of Dental Examiners (TSBDE) and Texas Society of Oral and Maxillofacial Surgeons (TSMOFS). Federal District Judge Sam Sparks ruled in favor of plaintiffs, in US District Court for the Western District of Texas, Austin Division (case no. A-14-CA-191-SS). Plaintiffs have a Constitutional right of commercial free speech. Judge Sparks’ ruling of January 21, 2016 can be accessed at this link: http://images.magnetmail.net/images/clients/AAID/attach/TEXAS_JAN_21_16.pdf

 

INTERVIEW

Dr. Davis:  Dr. Recker, I want to thank you for taking the time and effort to discuss with our readers, the merits and potential implications of this landmark case. As a former attorney/dentist member for the Ohio State Dental Board and also a practicing dentist, I know you place the public interest in a paramount position. How does Judge Sparks’ ruling positively impact the public welfare? How will the public benefit?

Dr. Recker:  The public benefits by having access to more truthful information about a dentist’s skill, knowledge and experience, which are reflected in certain credentials earned in various areas of dentistry. The Court recognized this, saw that the organizational plaintiffs were credible, bona fide and deemed worthy of holding themselves out as specialty organizations with the individual dentist/plaintiffs being entitled to hold themselves out as ‘specialists’ in their respective areas. Every practicing dentist understands that turf wars exist between various ADA recognized specialties. The regulation at issue protected ADA specialties, not the public.

You recall that the AAP came very close to changing its organizational name to include ‘Implant Dentistry.’ So you see an ADA recognized specialty nearly abandoning an underlying precept of the ADA specialty recognition process and attempting to falsely imply to the public that implant dentistry is an ADA recognized specialty, and a ‘subpart’ of the AAP. AAOMS also advertises as the ‘specialists’ in implant dentistry. These are misleading statements to the public, and made solely upon their respective opinions, and economics. There is no ADA specialty in implant dentistry, and implying so doesn’t change that reality and only risks confusing consumers.

There simply is no ADA recognized specialty in Implant Dentistry, Oral Facial Pain, Oral Medicine, and Dental Anesthesia. The public would clearly benefit if they knew that these specialties exist, but not recognized by the ADA.pull quote

As dentists who have been members of the ADA for many years, when we think ‘specialty’ we are conditioned to only think of the ADA. We don’t consider the fact that the ADA is a political body and its ‘Specialty’ decisions are ripe with considerations that should be excluded, such as competition, economic effects, and dental politics. The ADA specialty recognition process is effectively ‘dead.’ No other group will seek specialty recognition and be subject to such a process. There was a time, perhaps, that it made sense. But much has changed since the 1950’s, and the ADA House of Delegates made that painfully clear when it considered Anesthesia as a recognized specialty in October 2012.

Moreover, many potential ‘specialty’ areas of dentistry could never comport with the ADA requirements for ADA recognition. These areas include special needs dentistry, geriatric dentistry, cosmetic dentistry, forensic dentistry, and other focused areas that consist of real ‘specialists’ in those segments. Indeed, even a Board Certified (ABGD) general dentist might deserve the title (albeit perhaps a politically incorrect moniker) ‘specialist in general dentistry.’

 

Dr. Davis:  Numbers of doctors have expressed their concerns over this federal court decision. Some believe state dental boards have lost an ability to effectively regulate the practice of dentistry. Others fear any dentist who takes a weekend educational course at a Holiday Inn, may then be able to advertise a specialty status. Thus, dental specialty standing will have little to no meaning for the public. Can you address some of these concerns?

Dr. Recker:  First, there is no evidence that ‘dental specialty standing’ means anything to the public. When taking depositions of survey ‘experts,’ they give their own opinion (not having a clue about what an ‘ADA recognized specialty’ is or how it comes to be) that a ‘specialist’ in any area of endeavor is someone who has acquired additional education, training and experience in a specific topic or area. That is indeed a very true answer. When Courts declare the sole reliance on an ADA specialty for advertising purposes to be unconstitutional, it will not specify what a constitutional option might be. It cannot legislate a ‘fix.’ But based on the cases over the past 15 years, a ‘bogus’ credential or certification could not meet judicial opinions as to ‘bona fide’ and ‘legitimate.’

I try to tell my American Board of Dental Specialties (AADB) colleagues that a board ALWAYS has the right and the power to determine such a bogus credential as inherently misleading, because it has no underlying rigorous, objectively verifiable criteria upon which to deem itself a specialty credential. While a dental board may not be able to define ‘pornography,’ it will know it when it sees it, i.e., ‘specialist in cosmetic dentistry’ based upon a week long course provided by a company that produces veneers, etc.

 

Dr. Davis: Some dentists have expressed their frustrations over what may viewed as unfair insider influence, at American Dental Association (ADA) House of Delegates (HoD) meetings. Organizations petitioning for ADA specialty standing and fully meeting the standards of specialty status (via the ADA’s Commission on Dental Accreditation or CODA) have met with roadblocks. In the case of the specialty of dental anesthesiology, insider groups have stymied attempts at specialty standing for over three decades. Obviously, your clients must feel exasperated by entities which place protection of economic turf foremost. The recently formed American Board of Dental Specialties (ABDS) seems a response to this obstructionism. http://dentalspecialties.org/about-the-abds/

Dr. Recker:  I do see this point in the evolution of dental specialties as one that clearly offers the opportunity for advancement in training, education and experience in all non-ADA recognized specialties and for developing a fair and objective alternative for determining dental specialties. The ABDS (American Board of Dental Specialties) was formed to model the ABMS medical model. It is intended to be a joint cooperative between an independent entity (ABDS) and, hopefully, organized dentistry (ADA). The decisions of the ABDS relative to specialties will not consider competition, political issues, or turf wars. It will not be a decision made by a group of competitors who could be economically or politically affected by their own decisions. While such a statement is not intended to be critical of the ADA specialty recognition process, it is a simple reality.

While the four organizational clients in the Texas litigation have been critical of the ADA process, they simply came to realize that the ADA process is the ADA, trade association, process. If you don’t like the game, don’t play it. From a constitutional standpoint, the ADA can do whatever it wants relative to being deemed an ‘ADA recognized specialty.’ But when it comes to simultaneously deciding (by state adoption of only ADA specialties in advertising) the commercial free speech rights of dentists who may not even be members of the ADA, the First Amendment will intervene.

 

Dr. Davis:  In my reading of Judge Sparks’ ruling, and in particular the deposition of the TSBDE executive director, I was taken aback by an unwillingness or inability of state regulators to place the public interest to the fore. Defendants didn’t seem to make a case beyond a blind obedience to ADA rules and protocol. Please comment, Dr. Recker.

Dr. Recker:  The State Board of Texas couldn’t produce even one consumer complaint about dental advertising, of any kind. However, they did produce multiple complaints by dentists against other dentists! The Board did not concern itself with what might actually benefit the public, or assist the public in making informed choices. Just look at the dental anesthesia observation made by the Court.

A dentist/anesthesiologist in Texas was allowed to announce a practice concentration or limitation to dental anesthesia, but only if ‘General Dentist’ was included in the ad. That nonsensical requirement is hardly calculated to prevent the public from being ‘mislead,’ as opposed to protecting segments of the dental profession who want to monopolize the provision of general anesthesia services with the ‘help’ of the Board of Dentistry. Perhaps state boards will become more sophisticated and objective as a result of the FTC v NC Board decision. But I think it will take time for the average dentist to absorb developments in the law, and how their traditional thinking needs to evolve with the law.

 

Clearly, as the depositions indicated, members of the Board don’t know the details of the ADA specialty process. And interest into how that process works should be paramount to any dental board member before they limit the advertising by licensees to only ‘ADA recognized specialties.’ If they simply wanted to gain an insight into that process, they need only read the transcript of the 2012 HOD discussion of anesthesia’s application for specialty recognition. And in this age of obvious FTC scrutiny, I am amazed that there hasn’t been an antitrust challenge yet. But my concern is simply the First Amendment, and it provides sufficient protection to ‘unlock’ a state’s total deference to the ADA as the exclusive means to announce

 

Dr. Davis: I realize this case was adjudicated in federal district court in Texas. Other states like Florida and California have had similar judgements. Do you believe there will be protracted legal battles in numbers of future courts, or the will the ADA House of Delegates step-up and take more reasonable measures towards specialty acknowledgements?

Dr. Recker:  I am very hopeful that the ADA will acquiesce to the realities of the legal arena. That could result in ADA participation in the ABDS process. The ABDS is also hopeful that the ADA recognized specialties apply for ABDS recognition. A court would not challenge a state law that allowed specialists, recognized as such by the ADA or the ABDS, to advertise as specialists. Only when a law limits or prohibits commercial free speech will it be challenged. I would hope that protracted legal battles could be avoided by constructive dialog among the interested stakeholders in this issue. Ultimately, the ADA House of Delegates will need to decide if they want to work with the ABDS, or continue to resist any designation of specialty that is not their own. If states decide to continue to adhere to only ADA specialties, more states will pay more money in defending such a position. As we know, the States of California and Florida paid almost two million dollars collectively in their unsuccessful attempts to limit specialty recognition to only ADA determinations.

 

CONCLUSION

Dr. Davis: Dr. Recker, this has been a very detailed and highly insightful discussion. I realize legal issues in dentistry may seem overly complicated and “in the weeds”. However, it’s positive to see these matters fully open in the light of day. We all benefit from transparency in the process. I know numbers of readers may wish to contact you on matters relating to dental law.

Dr. Recker:  I feel strongly that any dentist wishing to learn about these issues should carefully read several relevant court decisions that explain the legal rationale underlying past First Amendment challenges about advertising credentials, and specialties. And, as a Life Member of the ADA, I completely understand a dentist’s ‘mother and apple pie’ allegiance to the ADA. But I also feel that diverting the specialty process to an independent outside entity will enhance, and prolong, ‘mother’s’ quality of life!

To that end, I would be happy to communicate with any person or group about these issues, via email or phone, time permitting. Recker@ddslaw.com; 800-224-3529.

Related:

Supreme Court of the United States Opinion - North Carolina State Board of Dental Examiners v Federal Trade Commission.