Thursday, March 14, 2019

Private Equity Firm Arby Partners Invests in Dental Service Orgainization Dr. Dental Management, LLC

Abry Partners has made an investment in Framingham, Massachusetts-based Dr. Dental Management, a dental management service organization. No financial terms were disclosed.

March 13, 2019
PRESS RELEASE
BOSTON–(BUSINESS WIRE)–Abry Partners (Abry), a Boston-based private equity firm, today announced that it has completed a strategic investment in Framingham, Mass.-based Dr. Dental Management, LLC (Dr. Dental), a dental management service organization that provides comprehensive management and administrative services to Dr. Dental-branded offices.

Dr. Dental has a unique playbook for growth, successfully scaling the company exclusively through new site openings to become one of the largest dental management service organizations in New England, with 100 active dentists treating over 250,000 patients a year. With this infusion of capital from Abry, Dr. Dental will continue to expand organically by opening new locations but will now also target strategic acquisitions of dental practices and groups throughout the Northeast.
Dr. Dental was founded in 2004 by the brother and sister team Alex Faigel, CEO, and Dr. Julia Faigel, DMD, clinical director, with the mission of providing quality dental care and great service at a lower cost in convenient neighborhood locations. The organization has grown from a single location to now 44 locations with 250 operatories throughout Massachusetts, Connecticut, New Hampshire and New Jersey.

The Dr. Dental management service organization supports its patient-care locations in all non-clinical aspects of dental practice, including staffing, patient scheduling, billing and collections, financial reporting and analysis, group purchasing, payroll, marketing, education and training. This suite of services enables affiliated dentists to focus exclusively on delivering high-quality patient care, making Dr. Dental one of the leading brands as measured by patient satisfaction in the Northeast.
“Abry’s investment in Dr. Dental is a true testament to our company and the dedication of our doctors and their loyal patients,” said Alex Faigel, Dr. Dental’s co-founder and CEO. “We’re excited to build on our recent growth with Abry Partners and look forward to all that we can achieve together. By combining our first-rate reputation and expertise in organic growth with Abry Partners’ resources and guidance for strategic acquisitions, we see Dr. Dental achieving record growth and rapidly expanding its footprint over the next few years.”

The funds will also be used to hire additional management and administration staff, and expand marketing and brand awareness for Dr. Dental and its affiliates. Dr. Julia Faigel and Alex Faigel will continue in their current management roles and run day-to-day operations.

“We see a very bright future for Dr. Dental,” said T.J. Rose of Abry Partners. “Alex, Julia and their team have built a strong business ripe for further growth. This investment perfectly aligns with Abry’s multi-site healthcare specialty platform – including dermatology, dental, autism and urgent care – and we look forward to leveraging our expertise to help accelerate growth organically by expanding with new locations and through acquisitions.”


About Dr. Dental Management
Headquartered in Framingham, Mass., Dr. Dental is a leading Dental Management Service Organization (“DSO”) in New England. Dr. Dental has 44 branded locations across four states (Connecticut, Massachusetts, New Hampshire and New Jersey). Dr. Dental is focused on providing quality and affordable care for all and has established itself as a leader in patient satisfaction. For more information, visit www.mydrdental.com.

About Abry Partners
Abry Partners is one of the most experienced media, communications, and information services sector-focused private equity firms in North America. Since its founding in 1989, the firm has completed over $80 billion of transactions, including leveraged buyouts, growth financings and recapitalizations. Currently, Abry manages over $12.0 billion of capital in its active funds.

Dr. Dental Locations 
Arby Partners Portfolio

Thursday, February 21, 2019

Xerox Pays $236 Million to Settle State of Texas Dental Fraud Case Legal Team: Whistleblowers Dr. Christine Ellis, Madelayne Castillo, Yarubi Morales and others Are Vindicated

Xerox Pays $236 Million to Settle State of Texas Dental Fraud Case
Legal Team: Whistleblowers Dr. Christine Ellis, Madelayne Castillo, Yarubi Morales
and others Are Vindicated


AUSTIN, Feb. 20, 2019 – The $236 million settlement of the State of Texas’ Medicaid fraud
claims against Xerox Corp. business units vindicated whistleblowers Dr. Christine Ellis,
Madelayne Castillo, Yarubi Morales and other whistleblowers, their legal teams said today. The
settlement is the largest recovery ever in a healthcare fraud recovery suit in Texas for Medicaid
related claims.

The State’s lawsuit alleged that Xerox violated the Texas Medicaid Fraud Prevention Act and
“rubber-stamped” prior authorization requests by unqualified clerical employees, allowing “vast
numbers” of orthodontic procedures for children whose condition did not meet Medicaid criteria
for treatment. The company, formerly known as Affiliated Computer Services, Inc., before Xerox
acquired it, also was accused of making false statements or representations in Medicaid filings
with the state.

Dr. Ellis, an orthodontist in Dallas, testified before a congressional committee in Washington in April 2012 about alleged Medicaid fraud in orthodontic billings by Texas dentists.

Ms. Castillo was an employee of the now-defunct All Smiles dental chain and West Texas Dental. Ms. Morales was a former employee of the now defunct All Smiles dental chain and Rodeo Dental.

Dr. Ellis, Ms. Castillo, Ms. Morales and several other whistleblowers all filed suits approximately
two years before the State filed its suit. The State has acknowledged that the facts underlying its
suit are the same as those underlying the whistleblowers’ previous filings.

Xerox became the state’s Medicaid administrator in 2003. Between 2004 and 2012, Texas
expended approximately $1.1 billion on orthodontics under the Texas Medicaid program.
According to the State’s lawsuit, Xerox, and ACS, Inc. before it, repeatedly represented to Texas
Medicaid officials that their prior authorization system ensured proper predeterminations of
qualifications.

Ms. Castillo, Ms. Morales and several other whistleblowers who filed cases against ACS/Xerox
are represented by Rusty Tucker of the Law Offices of James R. Tucker, P.C. of Dallas and MikeTibbals of Dallas. Ketan U. Kharod, of Guerrero & Whittle, PLLC, of Austin, Charles S. Siegel
and Caitlyn Silhan, of Waters and Kraus, of Dallas, Daniel L. Hargrove, of the Hargrove Law Firm
of San Antonio, and James R. Moriarty, of the Law Office of James R. Moriarty of Houston
represent Dr. Ellis.

Charles Siegel of Waters and Kraus said, “Because of Dr. Ellis and other whistleblowers who
brought lawsuits against ACS/ Xerox, the State of Texas ultimately showed how Xerox and ACS,
Inc. deeply compromised the integrity of the Texas Medicaid program. They faced vicious legal
attacks in their courageous efforts to set the record straight.”


Rusty Tucker of the Law Offices of James R. Tucker, P.C. said, “Our legal team hopes this
settlement sends a strong message that companies that prey upon Texas families and defraud the
state will face the judgment of the courts. Companies who commit unlawful acts in violation of
the Texas Medicaid Fraud Prevention Act will be held accountable. Dr. Ellis, Ms. Castillo, Ms.
Morales and other whistleblowers who came forward should be recognized for helping expose this
massive fraud.”

The case is “The State of Texas v. Xerox Corporation, et al.,” Cause No. D-1-GV-14-000581 in
the 53rd Judicial District of Travis County, Texas.

CONTACTS:
Rusty Tucker, Law Offices of James R. Tucker, P.C. (214) 505-0097
Charles Siegel, Waters and Kraus (214) 357-6244
James Moriarty, Law Offices of James R Moriarty (713) 857-1212

Wednesday, February 20, 2019

After WFAA investigation, company settles with State of Texas for record $235.9 million

Xerox Corporation and its former subsidiary, Conduent, agreed Tuesday to a record $235.9 million settlement with the State of Texas, according to the Texas Attorney General's Office. 
It was the largest single Medicaid fraud-related settlement in a case filed by the Texas Attorney General.

The settlement comes after a three-year WFAA investigation that uncovered millions of dollars in alleged overbilling by Texas dentists targeting low-income children for unnecessary and often harmful dental and orthodontic work.

Read entire story at WFAA website

Related:

 WFAA's Byron Harris reports 

Saturday, February 16, 2019

Tailwind Capital's Dental Service Organization Investments: Benevis and Lone Peak

Just an FYI, since I'm sure this information will be needed one day:

Smiles 4 Kids, which had been purchasing many old Small Smiles clinics and Kool Smiles are both now operated by Tailwind Capital.

Benevis is Kool Smiles and Resolution Dental
Lone Peak is Smiles 4 Kids as well as a few other names.


Financing for Benevis's sale to Tailwind seems to be, in part,  by New Mountain Finance and happened during the 1st quarter of 2018. Probably before the ink on the Kool Smiles settlement was dry. 

In a May 2018 conference call transcript New Mountain states:
Our new investments were highlighted by a larger-size directed origination of a unitranched loan for Benevis, several club deals including a loan to ACA Compliance and one addition to both our net leased portfolio and our SBIC investing program. We believe that the consistency of our deal flow in this competitive market shows the strength of the broad sourcing network that we have built.
(unintranched debt: debt is a type of structured debt that obtains funding from multiple participants with varying term structures.)
 

In their 2018 holdings report, Washington State Investment Board is invested is Tailwind and New Mountain.


Although Benevis still shows up on FFL Partners website's portfolio page,  it is listed under the "Former" tab on their website.

Tailwind Captial Portfolio
FFL Partners Portfolio

Thursday, February 07, 2019

Toddler who died after dental procedure at Kool Smiles was hooked up to empty oxygen tank as staff muted heart alarm: lawsuit

Toddler who died after dental procedure was hooked up to empty oxygen tank as staff muted heart alarm: lawsuit

Jan 9, 2019

The heartbroken family of a 2-year-old boy who died after a visit to the dentist last year is suing the Arizona clinic, claiming that a staff member repeatedly muted the alarm on a heart monitor that he was hooked up to, and that the oxygen tank he was supposed to be receiving supplemental air from was either faulty or empty.

Zion Gastelum’s mother, Veronica, brought her son to the Kool Smiles dental clinic in Yuma in December 2017 after it was determined that the boy needed crowns to address severe cavities. According to a police report obtained by ABC 15, Aaron Roberts was contracted by the clinic and was supervising the procedure, and a dentist later told responding officers that the procedure had gone “well.”

According to the family’s lawsuit, while under general anesthesia Zion had nine of his baby teeth worked on, including root canals and crowns on six of them. The complaint alleges that X-rays or further investigative exams were not conducted to confirm that the nine procedures were necessary.

Read more here.


Related:

Police report offers new details in case of 2-year-old who died after Yuma dental appointment

DOJ: Kool Smiles dental clinics to pay $23.9 million, allegedly submitted false claims

Saturday, January 19, 2019

150 families have now filed lawsuits in Orange County Superior Court , Santa Ana, California against Children’s Dental Group — Number is expected to grow

By Deepa Bharath | dbharath@scng.com | Orange County Register
PUBLISHED: January 16, 2019 at 6:11 pm | UPDATED: January 18, 2019 at 2:19 pm
                              
IRVINE — Sixty-five families whose children were infected by rare bacteria when they underwent pulpotomies, or “baby root canals,” at an Anaheim clinic two years ago filed a lawsuit Wednesday, Jan. 16, naming the clinic, its operators, the company that installs and maintains water filtration systems, and several dentists.

The lawsuit, which was filed in Orange County Superior Court in Santa Ana, alleges that Children’s Dental Group and dentists who provided services there performed hundreds if not thousands of unnecessary pulpotomies on children. Potentially deadly Mycobacterium abscesses was found in several samples the county’s Health Care Agency took from the clinic’s water system. 

The children, ages 3 to 9, all underwent pulpotomies at the clinic between April and July 2016. In all, 500 children underwent the procedure during that time.

Children’s Dental Group has since become part of Western Dental. The clinic in question on East Lincoln Avenue is not owned or operated by Western Dental, but has changed hands.
So far, 150 families have filed lawsuits against the clinic and the number is expected to grow, said Dan Hodes, Irvine-based medical malpractice lawyer who is representing the children and their families.

READ THE ENTIRE UPDATE ON THIS STORY HERE






Saturday, November 17, 2018

New Complaints About Lone Peak Management Group and Smiles 4 Kids Dental Clinics



Pediatric dental chain faces new complaints

By: Alison Grande
Updated: Nov 16, 2018

A new complaint was filed against a local pediatric dental chain, Smiles 4 Kids. The chain is managed by Dr. Justin VanBibber and owned by Lone Peak Management.

The latest complaint was filed by the Washington State Dental Association with the Department of Health and the Dental Quality Assurance Commission. The complaint alleges the dental offices in the chain, only refer patients to their other practices for oral surgery or orthodontia.

Dr. Chris Delecki is the president of the Washington State Dental Association.

"They're failing to disclose the fact the patient has other options besides their self-referrals to their own managed practices," said Dr. Chris Delecki, President of the Washington State Dental Association.

"Patients are often being asked to travel from Tumwater to Tacoma for their orthodontic care and these are Medicaid patients and for many of them transportation is one of the biggest things they face.
he complaint includes an email apparently sent by the Smiles for Kids Regional manager to office managers.

"Patients in your offices should NOT be given options as to where they would like to go for their wisdom teeth extractions -- referring patients anywhere else is sending OUR business and money away and is therefore, unacceptable."

Read the entire report here.

Thursday, November 15, 2018

Washington State Dental Association: LOCAL DENTAL CLINICS OPERATED BY LONE PEAK MANAGEMENT ENGAGED IN DANGEROUS AND DECEPTIVE PRACTICES

image
Contact: Bracken Killpack
206.973.5227; bracken@wsda.org
LOCAL DENTAL CLINICS OPERATED BY LONE PEAK MANAGEMENT
ENGAGED IN DANGEROUS AND DECEPTIVE PRACTICES, COMPLAINTS ALLEGE
Practice at Smiles 4 Kids, Kids Dental, Family Orthodontics Put Patients at Risk
and Cost Low-Income Families
TACOMA – November 13, 2018 – The Washington State Dental Association (WSDA) has filed a new complaint with the Washington State Department of Health, alleging dental clinics operated by Lone Peak Management Group, LLC (Lone Peak) are engaging in dangerous and deceptive practices.
The WSDA complaint is just the latest complaint against Lone Peak, which operates more than a dozen clinics in Washington state, specializes in pediatric dentistry, and serves a high percentage of low-income, Medicaid-eligible patients.

The WSDA complaint was filed after research into Lone Peak practices. It alleges that the chain arranged a kickback scheme that generated nearly $170 for Lone Peak every time a patient was administered general anesthesia. Disguised as a “facility use fee” charged to the anesthesia provider, these payments far exceeded fair market value of the record-keeping Lone Peak provided the anesthesia provider, generating substantial additional profit for Lone Peak.

Dentists and staff in Lone Peak offices also were directed to engage in a system of self-referral to affiliated clinics for specialty dental services like oral surgery and orthodontia. This system ignored patient preferences and in many cases resulted in families traveling significant distances to affiliated clinics when other qualified providers were nearby.

Internal Lone Peak documents cited in the complaint clearly demonstrate the profit motive behind this policy: “Patients in your office should NOT be given options as to where they would like to go for their wisdom teeth extractions,” reads one email. “Regardless of how near/far the office … referring patients anywhere else is sending OUR business and money away and is therefore unacceptable.”

Previously, Seattle’s KIRO 7 TV reported on another whistleblower complaint against Lone Peak, filed by a former office manager who left the company after refusing to follow directives from company managers to re-use dental mouthpieces that are intended for single-use only.
Internal company emails cited in the whistleblower complaint show Lone Peak putting profits ahead of patient safety. In one email regarding the reuse of mouthpieces, a Lone Peak executive lamented the fact that “our expenses would go through the roof if we didn’t find a way around” the single-use requirement.

The emails also describe how Lone Peak ignored concerns raised by at least one clinic dentist about the reuse of single-use mouthpieces. Lone Peak agents directed dental office staff to deceive that dentist: “We should probably hide our open Isolites (mouthpieces) on the days we know she is coming in,” wrote a Lone Peak agent. “In the meantime, just make her happy when she is around, and then go back to business as usual when she leaves.”

“The concerns brought forward by the whistleblower and uncovered by our team are deeply troubling and represent a dangerous corporate intrusion in the doctor-patient relationship,” said Dr. Chris Delecki, president of the Washington State Dental Association. “This speaks to what can happen when corporations are allowed to directly or indirectly own dental practices. In this environment, corporations can direct, question and over-rule the decisions dentists make in how to best treat their patients. This is why our association has consistently advocated for state laws to prohibit this type of interference and why we have engaged in bringing these practices to light.”

Washington law prohibits corporations, including dental service organizations (DSOs), from practicing dentistry, which includes directing a dentist’s treatment plan; limiting or imposing requirements on how a dentists uses equipment or materials in the provision of treatment; or limiting or imposing requirements on the materials, supplies, instruments or equipment a dentist deems necessary to provide diagnoses or treatments consistent with the standard of care.

Lone Peak is a DSO headquartered in Colorado that manages approximately 50 dental clinics in 12 states, including Washington. Lone Peak is owned by Tailwind Capital, a private equity firm whose stated mission is to transition businesses to become “larger, more profitable enterprises.”

Documents received by WSDA indicate that certain executives of Lone Peak may also have been involved with the Small Smiles dental chain DSO, and a number of Lone Peak dental offices formerly may have been Small Smiles dental offices. Small Smiles was included in a scathing 2013 US Senate report that found the chain performed unnecessary services and that its business model deceptively gave managers rather than dentists control over the clinics. The report also recommended that Small Smiles be excluded from participating in the federal Medicaid program. 

Small Smiles and its parent company, Church Street Health Management (CHSM) have faced litigation before. In 2012, Small Smiles paid $24 million to settle allegations of Medicaid fraud brought by the U.S. Department of Justice. And in 2015, Small Smiles agreed to pay nearly $39 million in claims for alleged “unnecessary, inappropriate, unsafe, and excessive dental procedures.” Church Street Health Management has since declared bankruptcy.
 
The most recent complaints here in Washington also name Justin VanBibber, a Utah-based dentist who serves as the nominal head of the clinics engaged in the kickbacks and the mouthpiece reuse practice. He is listed as a practicing dentist on Lone Peak clinic websites in Washington, but the profile for his South Jordan, Utah practice lists him as a resident of Utah.
The Washington State Department of Health has opened active investigations into Lone Peak’s and VanBibber’s practices.


About the WSDA
The Washington State Dental Association’s 4,400 member dentists are committed to solutions that prevent disease and ensure quality oral health for all Washingtonians. WSDA empowers its members to advocate for and provide optimal oral health care.






















Saturday, November 03, 2018

Law Offices of James R. Moriarty: $5.1 Million Settlement in Whistleblower Case Involving Samson Dental Partners, LLC and ImmediaDent of Indiana, LLC

HOUSTON, Nov. 2, 2018 /PRNewswire/ -- Samson Dental Partners, LLC and ImmediaDent of Indiana, LLC agreed to pay $5.1 million to the federal government, the State of Indiana, and a whistleblower dentist to resolve a qui tam case with fraud allegations, according to the legal team for the dentist.

A settlement agreement was entered into among the U.S. Department of Justice (on behalf of the Office of Inspector General of the U.S. Department of Health and Human Services), the Medicaid Fraud Control Unit of the Office of the Indiana Attorney General, and Jihaad Abdul-Majid, DDS.

The qui tam complaint alleged that the defendants engaged in illegal corporate practice of dentistry and various types of fraud, including fraudulent billing, excessive and unnecessary treatments of excessive patients, and a sustained pressure by non-dentists in management positions to place corporate profits over patient care by exerting undue influence on dental care decisions.

Dr. Abdul-Majid, who will receive $925,000 plus expenses, attorneys' fees and costs, is represented by Charles S. Siegel, of Waters & Kraus, LLP, of Dallas; Daniel Hargrove, of The Hargrove Law Firm, P.C., of San Antonio; James R. Moriarty, of the Law Offices of James R. Moriarty, of Houston; and Joseph D. Satterly and Paul Kelley of Satterly & Kelley, PLLC, of Louisville, Ky.

According to the settlement, the federal government and the state of Indiana contend that they have certain civil claims against Samson Dental Partners, LLC and ImmediaDent arising from the submission of false claims for payment to Medicaid during the period from Jan. 1, 2009, through Sept. 30, 2013, for the following conduct:

  • Samson Dental Partners, LLC engaged in the corporate practice of dentistry in violation of Indiana state law by exerting obtrusive influences over ImmediaDent's medical professionals and staff by rewarding production and disciplining for not meeting production objectives and directing personnel in a manner which compromised clinical judgment;
  • Samson Dental Partners, LLC and ImmediaDent upcoded simple tooth extractions and improperly billed them as surgical extractions; and
  • Samson Dental Partners, LLC and ImmediaDent improperly billed for scale and root planing (deep cleaning) when they were either not performed or not medically necessary.

ImmediaDent operates nine dental care practices in Indiana. Samson Dental Partners, LLC, headquartered in Kansas City, Mo., provides administrative and other support services to ImmediaDent.

The case is "United States ex rel. Jihaad Abdul-Majid, et al. v. ImmediaDent Specialty, P.C., et al.," Civil Action No. 3:13-cv-222-CRS in the U.S. District Court for the Western District of Kentucky. The case was originally filed on Feb. 20, 2013 by Dr. Abdul-Majid. The federal government and the state of Indiana intervened in the case in September 2018.

The lawsuit alleged violations Federal False Claims Act, 31 U.S.C. § 3730(b), and the Indiana False Claims and Whistleblower Protection Act, Indiana Code 5-11-5.5-4.

The settlement agreement is neither an admission of liability by SDP and ImmediaDent nor a concession by the federal government and the state of Indiana that their claims are not well founded.

CONTACTS:

Charles S. Siegel
Waters & Kraus, LLP
(214) 357-6244
siegel@waterskraus.com
www.waterskraus.com

Daniel Hargrove
The Hargrove Law Firm, P.C.
(210) 710-2867
dh@hargrove-law.com

James R. Moriarty
Law Offices of James R. Moriarty
(713) 528-0700
jim@moriarty.com
www.moriarty.com

Joseph D. Satterly
Satterly & Kelley, PLLC
(502) 785-8758
jsatterley@satterleylaw.com
www.satterleylaw.com

Paul Kelley
Satterly & Kelley, PLLC
(502) 785-8758
pkelley@satterleylaw.com
www.satterleylaw.com

SOURCE Law Offices of James R. Moriarty

Related Links

http://www.moriarty.com

Friday, October 26, 2018

Smiles 4 Kids Dental Clinics Under Investigation in Washington State

Smiles 4 Kids is “managed” by Lone Peak Management Group (LPMG), located in Colorado. Tailwind Capital.  In January 2017, Tailwind Capital purchased a controlling interest in LPMG for $55M.  Waller Law Group represented LPMG.  In press releases at the time, it was stated LPMG had nearly 50 clinics in 12 states.  As of March 2018 I counted 59 clinics and 73 known business entities. But as always, I could be wrong. (smile)

Let me just say this is only the tip of the iceberg about this company.

Below is the excellent report, by Alison Grande, that aired October 25, 2018 on KIRO7 News.

Whistleblower: Local pediatric dental chain reusing disposable tools
image
By: Alison Grande
Updated: Oct 26, 2018 - 6:19 AM

The Washington State Dental Quality Assurance Commission is investigating after a whistleblower complaint accused a local pediatric dental chain of re-using dental tools.

Lisa Walker quit her job as the office manager at the Smiles 4 Kids at Allenmore Hospital in Tacoma after she says the dentist overseeing the businesses, Dr. Justin VanBibber, told her to re-use disposable Isolite mouthpieces.

"That we re-use the Isolites, he asked that I put them in the cold sterile and re-use them on patients and I refused," said Lisa Walker.

The Isolite Mouthpiece package is clearly labeled "Disposable. Do not re-use. Re-use can result in the transmission of infections, pathogens."

Isolite mouthpieces are used to keep the airway clear during a dental procedure. "It suctions out the blood, the saliva, pus, tooth decay, you name it -it keeps the airway free of debris," described Walker.
"The worry for my kids and it was my worry for all kids is that,  I mean we have hepatitis B, hepatitis C, there's HIV, I mean there's numerous numerous diseases and long-term illnesses that can be contracted through blood."

Read entire story here.






Thursday, September 13, 2018

Massachusetts Dentists Support Independent Practitioners

13 Sep 2018 Jill Tanzi, DDS

Todays Dental News

Most dentists in the United States have not heard of the Massachusetts Dentists Alliance for Quality Care. We are a group of dentists who are passionate about private practice and maintaining an excellent standard of care in our profession and for our patients.

In recent years, many of us have felt that organized dentistry’s advocacy for private practice has declined. In all fairness, not every dentist is in private practice. Many are working for dental service organizations (DSOs), academia, insurance companies, and other fields. The ADA and state organizations represent all dentists, not just one special interest group.

Last year, several dentists in Massachusetts decided to seek legal advice and petition our Attorney General in response to a contract received from Delta Dental of MA (currently called Total Choice PPO). Not only did we raise enough money to file a formal petition with the Attorney General, but we also formed a group that has grown to more than 60 members today.

In July, we voiced our concerns to the Division of Insurance at a hearing regarding a “new fee methodology” proposed by Delta Dental that would automatically decrease reimbursements to the entire network of Premier providers in the state. To date, we continue to educate our legislators and advocate for private practice dentists, as well as mentor students and recent graduates.

Although Delta Dental’s new for-profit Total Choice PPO was approved in our state, Delta continues to sell the non-profit Premier plan (96% of dentists in Massachusetts are Premier providers). In June of this year, it was announced that our state dental society decided to make a deal with Delta Dental of MA to cut all of the Premier dentists’ reimbursements by 10%.

This 10% “recalibration,” a euphemism for lower reimbursements, will affect that 96% of dentists in our state. Conversely, the Total Choice plan that offers a larger 30% discount has not been less popular with employers in Massachusetts and has far fewer contracted participating dentists.

Many dentists in our state understand these subtleties and were extremely upset by the decision of the leadership of the Massachusetts Dental Society, while other dentists may not be paying attention to these small details or fear retribution for getting involved.

Now is not the time to sit back and let others figure out the details that affect the future of our profession. Do you recall what has happened to primary care physicians? Not only have they been forced to work increasingly faster by insurance companies, but the quality of patient care also has suffered as a result. This is especially important for the younger generation of dentists to understand, as they will need to work faster and longer hours to try to make a living with ever decreasing reimbursements and huge amounts of student loan debt.

It is our hope that organized dentistry in our country will learn from the mistakes of the American Medical Association and try to slow the corporatization of dentistry and the reliance on dental benefit companies. We would like to see more support for the private practitioner members who, in fact, serve most patients in our country.

The Massachusetts Dentists Alliance for Quality Care is continuing its work on behalf of our profession. We believe that by educating our legislators, we will have a stronger voice in our state government. We also believe there is hope for our future and welcome as many dentists who are interested in becoming part of this movement to join our group.

Stand up, fellow dentists. It is time to make your voice heard. The time to make a difference is now!

Dr. Tanzi, a graduate of the University of Maryland School of Dentistry, has more than 18 years of private practice experience. She started The Dentist at Hopkinton in Hopkinton, Mass, 15 years ago near the starting line of the Boston Marathon. Passionate about issues facing dentists and private practice, she is also a founding member of the MA Dentists Alliance for Quality Care, which advocates for private practice dentistry and high quality dental care for patients. She can be reached at jilltanzidds@hopdent.com

Related Articles:

Massachusetts Dental Society Strikes Delicate Balance in Delta Dental Discussions

Massachusetts Dentists Continue Battle Against Delta Dental

Emerging Advocacy Groups Support Small Business Dentistry

Saturday, September 01, 2018

Krista Szewczyk Posed as Dentist for 7 Years. Prosecutors and Dental Board Fail

Szewczyk was first accused of illegally performing dental procedures in 2012.  The District Attorney at the time decide not to pursue charges citing a conflict of interest since her husband was a Deputy Sheriff in Paulding.

Apparently, Szewczyk posed as a dentist through her mini-DSO, County Dental Providers. She also is reported to have performed dental procedures in the homes of patients.

At least one patient was sent to the hospital due to an abscess in his throat the size of a tennis ball.

People Magazine website reports:

In an interview with Atlanta TV station WGCL, Szewczyk said: “It’s definitely a personal vendetta” by the prosecutor. She added, “Sad situation … and I’m confident it will be handled in a timely manner.”Krista Szewczyk mugshot

The investigation into Szewczyk dates to 2013, when the Georgia Board of Dentistry alerted the district attorney’s office to complaints about Szewczyk, who ran a business called County Dental Providers starting in 2011 that contracted with independent licensed dentists to come in and work on patients, Donovan says.

The state board’s 2013 alert prompted a criminal investigation at the time that led to a single charge in Paulding County accusing Szewczyk of performing dental services without a license, the district attorney says. But on the DA’s recommendation, Szewczyk was enrolled in a pretrial diversion program that did not require her to enter a plea, and instead allowed for the charge to be dropped if she successfully completed the program.

“This was the only instance of which we were aware at the time, so we just said, ‘Don’t do this anymore,'” says Donovan. “I got a notice saying she had completed the program about the same time I heard from the Board of Dentistry that she was back at it again.”

There are indications Szewczyk is associated with Heartland Dental on her LinkedIn page which has been removed. Additionally her picture appears on Group Dentistry Now blog.

index


Heartland Dental Winter Conference, January 2018.






Related:

The Atlanta Journal-Constitution-Woman accused of posing as a dentist also under investigation in Cobb

Thursday, August 23, 2018

Why Picket Aspen Dental?

Why Picket Aspen Dental?

by Linda Reynolds

B.A.D. Soldier


What is B.A.D.?

B.A.D. is the acronym for Boycott Aspen Dental. We are a cause that primarily seeks to give a voice to the Aspen Dental victims who are not strong enough to speak out on their own. Alone we are faceless along with all the other Aspen Dental victims, but as a group we have a BEAUTIFUL face of courage with a BOLD name.  We desire to help victims of Aspen Dental because we too are a handful of victims that have been hurt; some of us worse than others.


Why has B.A.D. been created?

B.A.D. was created after experiencing my own personal Aspen Dental horror story, and after reading endless so it seems, online negative reviews about similar Aspen Dental experiences. I saw a need to create a centralized website so people can see the magnitude of thousands of voices screaming out the injustices of Aspen Dental; people who have never had their dental horror story told much less appropriately addressed by the company who caused the damage (ADM). B.A.D. is not about one individual; B.A.D. is a cause that seeks to bring Aspen Dental Victims together. We are one voice and one face: Boycott Aspen Dental.

How did you hear about Aspen Dental?

My insurance had limited options, and Aspen Dental was one of them. I searched the actual dentist for negative reviews, and couldn’t find any. Dr Mark Habermeyer was new at Aspen Dental, but he had several years of prior experience. It was just a simple crown replacement, so I made the appointment asking myself, “How could I go wrong?”

Unfortunately that one visit will cost $5000 to fix the errors made by the staff that day.

I’m still getting treated for this issue that was caused April/May of 2017, so I’m not sure if more will be added to that figure later.


Did Aspen Dental attempt to compensate for your pain and trouble?

They refused to refund my money at the time of the incident, which was when www.twothirtydentalcaution.org was created. Not a word was heard from Aspen Dental

until June of this year when I received a call from a staff member at Aspen Dental to say they’ve decided to refund my money. What? Over a year later they are doing this? So I get the check for $408, and then another call comes in a few weeks later to offer a settlement. Unfortunately they chose a figure I put out there a year ago, and which no longer covered all that I had gone through. Aspen Dental knew B.A.D. was soon to be revealed, and this apparently was their first vain attempt to stop it.

What do you mean by “vain attempt”?

They showed absolutely no concern whatsoever for all the pain I’ve endured. They attempted to entice me with a low ball offer, but what they failed to consider is I  already had concluded and accepted that I wouldn’t be getting any money from Aspen Dental. The plans for B.A.D. were in place (March 2017 is when the idea was conceived), so I was very suspicious when I received the first call that came a year afterthe incident with no previous attempts on record made by Aspen Dental to rectify this.

After they realized I wasn’t going to take the bait of the second call with the low ball offer, three ladies from Aspen Dental Management Corp offices in Syracuse, NY called me again to attempt to convince me to take the low ball offer. When that didn’t work, they hired an attorney with threats to close us down, and yes that low ball offer was included once more.

What about the threat of a lawsuit?

The day Aspen Dental sues its victim is the day the world will know that Aspen Dental is guilty of all they are accused of doing and more. This victim will never shut up. They don’t have the power to destroy B.A.D. like they would like us to believe. For example, if by chance they were able to have our websites removed with their money, well there was a day we didn’t have the Internet and word still traveled about upcoming events. We will revert back to sending telegrams if we have to, but B.A.D. will be around for months, years and decades to come. Aspen Dental we are not going away until you stop hurting innocent people.

Does Boycott Aspen Dental have an attorney?

We are suiting up for battle, let’s leave it at that.

What is on the agenda of B.A.D. for the short term?

Please visit our website www.boycottaspendental.com to learn of our current goals as we are planning our grand opening October 6, 2018. That’s when we will reveal our first fundraiser for an Aspen Dental victim to be chosen by member voting. We will also have our first Aspen Dental picket on that day (locations to be announced).

What is on the agenda of B.A.D. for the long term?

To tell as many people who will listen, Stay Safe; Stay AWAY from Aspen Dental!

To have an annual picket at every Aspen Dental location until Aspen Dental STOPS preying on innocent people, often times low income seniors, people with disabilities and children of low income families. If you are an Aspen Dental Victim or know someone who is, please consider joining B.A.D. today!

Sunday, August 19, 2018

FLOSS Dental owner had questionable dental past before closures


imageAugust 16, 2018 AUSTIN (KXAN) — A lawsuit filed within Travis County details allegations against Dr. Clinton Herzog from FLOSS Dental, including that he is not a licensed dentist.

Plaintiffs claim Herzog collected hundreds of thousands of dollars from investors to open multiple locations for his dentistry in Austin, then never bought them and left the city. They also say the State Board of Dental Examiners suspended his license in 2015, but allowed him to practice under certain conditions.

In 2016, Herzog voluntarily surrendered his license to practice, which the plaintiffs said they were not aware of. According to Texas State Board of Dental Examiners records, Herzog was accused of advertising that his offices had multiple "elite" providers for Invisalign services, but he was the only "elite" provider. Herzog is also accused of advertising dental services that "were free or discounted without disclosing the prices of associated services," according to his non-disciplinary remedial plan.

FLOSS Dental workers on Fifth Street in Austin told KXAN Herzog "left town" and they could not get a hold of him…

See report and read entire article here.


Image result for Clinton Herzog   Image result for Clinton Herzog

Is this the same Clinton Herzog? You decide.

Clinton Herzog – January 5, 2018 Charged with Driving While Intoxicated and Possessison of PG1 (Penalty Group 1*) Controlled Substance


Image result for Clinton Herzog

*Penality Group 1(usually Heroin, Meth or Cocain) Possession of less than one gram is a State Jail Felony which may result in confinement in a Texas State Jail Facility for a minimum of 180 days and maximum of 24 months along with a fine up to $10,000.

Related:

Clinton F. Herzog, DDS - Order of Tempoarty Suspension, April 28, 2016

The Happy Hour dentist who offers patients free booze before a cleaning, May 2011

Tuesday, August 07, 2018

Dazzling Smile Care PC and Dr. Shahrzad Haghayegh-Askarian Indicted on Medicaid Fraud Charges


August 7, 2018
BostonA Quincy-based dentist who was banned from the state’s Medicaid program has been indicted in connection with an alleged scheme to fraudulently bill MassHealth under another dentist’s name, Attorney General Maura Healey announced today.

Dr. Shahrzad Haghayegh-Askarian, age 43, of Norwell, was indicted by a Statewide Grand Jury on charges of Medicaid False Claims (2 counts) and Larceny over $1,200 (2 counts). Haghayegh-Askarian’s company, Dazzling Smile Care PC, located in Quincy, was also indicted on the same charges. 

An audit by the State Auditor’s Office uncovered Medicaid fraud committed by Dr. Haghayegh-Askarian. Following that audit, Dr. Haghayegh-Askarian agreed to a $300,000 settlement with the AG’s Office in 2015 and was terminated from participating in the MassHealth program. The settlement stipulated that she could only re-enroll with MassHealth if she met standards of compliance and instituted a monitoring program mutually agreed upon by Dr. Haghayegh-Askarian and the AG’s Medicaid Fraud Division.

The AG’s office alleges that, despite her termination from MassHealth, from April 2014 to December 2017, Dr. Haghayegh-Askarian continued to treat MassHealth patients and billed those services under the name and identification number of another dentist, without his knowledge or authorization. That dentist contacted the Office of the State Auditor to report this alleged fraudulent activity when he learned of it in September 2017. 

“I commend my staff and the staff of Attorney General Healey for their work to bring charges against Dr. Haghayegh-Askarian,” said State Auditor Suzanne Bump. “Her license should be immediately revoked, and her continued, brazen abuse of MassHealth should be punished.”

“This matter illustrates the commitment of all agencies to combat medical billing fraud which affects all citizens,” said Anthony DiPaolo, Chief of Investigations at the Insurance Fraud Bureau of Massachusetts. “The IFB places a high priority on fighting this type of insurance fraud. The collaboration in this matter is unprecedented.”

All of these charges are allegations and defendants are presumed innocent until proven guilty.
The matter was investigated by Assistant Attorneys General Jay McCormack and Kevin Lownds, Investigations Supervisor Lisa Bailey and Investigators April Waterhouse and Deborah ElMajdoubi, all of Attorney General Maura Healey’s Medicaid Fraud Division, with assistance from MassHealth, the Insurance Fraud Bureau of Massachusetts, the State Auditor’s Office, and Massachusetts State Police assigned to the AG’s Office.

Monday, July 16, 2018

Kool Smiles featured on CBS Whistleblower Series



 

Benevis/Kool Smiles Response to CBS Report:
Dr. Greenwald and Dr. Rai blew the whistle on Kool Smiles after they say they witnessed unnecessary dental procedures performed on children. CBS reached out to the company for a comment and they provided the following statements:

Statement from Kool Smiles:
"Our patients and their safety are our top priority and we will continue to work toward our mission of ensuring every child in America has a dental home. The settlement reached in December 2017 addressed treatment provided between 2009 and 2011, and was unrelated to the quality of dental care provided to patients. The company's compliance and quality assurance programs lead the dental industry and we continue to implement ongoing measures to ensure every patient receives the best care."

This past December, 2-year-old Zion Gastelum died four days after visiting the Kool Smiles office in Yuma, Arizona. Zion's death occurred just days after the Whistleblower suit was settled. The case had been in litigation for almost a decade.

Statement from Kool Smiles regarding death of Zion Gastelum:
"Kool Smiles treatment protocols follow the guidelines and best practices established by the American Dental Association and the American Academy of Pediatric Dentistry. Treatment is provided only after conducting a consultation and obtaining the informed, written consent of the patient's parent or guardian. Our dedicated dentists, anesthesiologists and the rest of our Kool Smiles family mourn this tragic loss."

Saturday, June 23, 2018

Dr. Behzad Nazari, D.D.S., ET AL. v. The State of Texas; Xerox Corp; and Xerox State Healthcare, LLC, f/k/a ACS State Healthcare, LLC, n/k/a Conduent Business Services, LLC

Despite all the claims, counter-claims, third, forth and fith party claims, here is the the short version:

Texas withheld reimbursement from several dentists due to a high suspicion of Medicaid fraud. Dr. Nazari, his clinic Antoine Dental and others argued they needed and deserved their money for all the honest and much needed work they had done on so many children with terrible orthodontic deformities and rotten baby teeth. They were the saving grace to the underserved population as they saw it.

Being royally pissed, Nazari suesTexas and Xerox (NYSE:XRX) (ACS) demanding his money.

The Feds (that is us, the US taxpayers) says “Hey Texas, we pay 50% of all you spend on Medicaid, and we want our money back!

Texas says, “We really have that kind of cash to hand back, we spent it already. But we will try to get it from Xerox. They ran the show down here for years. In fact we knew nothing about this until Byron Harris did a series of reports for WFAA in Dallas. We learned about it on the local evening news!”

Texas sues Xerox, under whatever name Xerox was using at the time. The suit ends up at the Texas Supreme Court.

Texas tells the Texas Supreme Court justices, it was no seeking actual damages from Xerox in a civil Medicaid fraud suit in a civil Medicaid fraud suit accusing the company of signing off on $1.1 billion in claims for orthodontic services without properly vetting them, and therefore the remedies it has sought aren't subject to proportionate responsibility calculations.

Xerox says that it is wrongly facing sole liability in the matter, despite the fact it trained paid employees to basically rubber stamp “Approvals” as fast as they could. Additionally, in early testimony it was learned they trained the dentists how to game the systems.

Yesterday, June 22, 2018, the Texas Supreme Court handed down its decision. Xerox, it is all on you guys. Pony up the $2 Billion!

Now, doing business as Conduent Business Services (CNDT) reports are that Conduent’s “benefit wallet” is empy and they will probably settle for $500 Million. 

Related:

Dentist the Menace blog posts on this matter

Case Details and Documents

Opinions posted on the SCOTX Blog

December 6, 2017 Oral Arguments Video

Saturday, April 28, 2018

Emerging Advocacy Groups Support Small Business Dentistry

image

20 Apr 2018 Michael W. Davis, DDS

Small business dentistry is increasingly establishing advocacy groups designed to address specific issues. Areas of concern range from protecting the doctor/patient relationship against the intrusion of the insurance industry and corporate dentistry to honest evaluation and solutions for the public’s “access to care.”

These associations are springing up in a variety of different states. Because of their distinctive smaller sizes, they are highly attuned to specific predicaments unique to a given state. Larger national groups may have multiple and conflicting agendas, which too often grind effectiveness to a standstill. These smaller spearhead organizations often serve as the initial testing ground for addressing and solving challenges. Many times, state dental associations will later pick up the banner and carry forth with their added weight and power of membership.

Three organizations that exemplify this movement are the Concerned Dentists of Texas (CDoT), the Concerned Dentists of Washington State (CDWS), and the Massachusetts Dentists Alliance for Quality Care (MDAQC). Each of these relatively small associations is free to examine problems unique to its specific state and discover optimal mechanisms for local problem solving. They aren’t handicapped by the political or economic motivations of a faraway distanced leadership. They aren’t bogged down by neverending and do-nothing committee meetings. And, they lack multiple layers of leadership hierarchy, which often hinders effective action…

Read Dr. Davis’ entire article here.

Thursday, February 22, 2018

Southern Dental Alliance and Sale to Pouschine Cook Capital

Keep in on your radar.


Sept 2017:

Deloitte Advises Southern Dental Alliance on Sale to Pouschine Cook

Deloitte Corporate Finance acted as exclusive financial advisor to Atlanta-based VSM Management d/b/a Southern Dental Alliance on its sale to Pouschine Cook Capital Management and its co-investor group.

Southern Dental is a multi-specialty dental service organization in the Southeastern U.S. with 32 clinic locations across eight brands.

“DCF’s assistance was indispensable for us throughout the transaction process, offering both expertise in the space and extensive resources. We are excited about our future growth prospects and the new partnership with Pouschine Cook,” said Mark Lakis, CEO of Southern Dental.

Tom Harbin, managing partner at Source Capital, echoed the sentiment, “DCF’s deep knowledge of the dental space was invaluable and helped lead to a successful transaction. We could not be more pleased with the outcome.”


http://www.abfjournal.com/dailynews/deloitte-advises-southern-dental-alliance-on-sale-to-pouschine-cook/