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.

Sunday, January 31, 2016

Attorney James R. Moriarty Responds to CRIME WATCH DAILEY: Pediatric dentist accused of mistreating young patients

For 6 years I have attempted to stop what I consider to be highly abusive dental mistreatment of our youngest and most vulnerable children, mostly without significant success. 

Dental abuse ranging from lying to the moms, pulling teeth without pain relief, grossly excessive use of stainless steel caps, unnecessary baby root canals and widespread use of physical restraint devices on infants as young as 18 months. 

For reasons I cannot comprehend, many of the honest and legitimate dentists sit silently, the dental boards responsible for policing dentist do nothing and most of the criminal and civil state authorities charged with protecting the public, and the taxpayers do little or nothing.  

I can identify hundreds of dental offices secretly and illegally owned by private equity firms ranging from the money behind the propane gas we use to cook on in the back yard, billionaires from the middle east and even the husband and wife who started one of the largest computer companies in the world.  

I've complained at every level of county and state government and produced evidence to show this illegal and abusive conduct.  All almost for naught.

One 27 year old Medicaid mom, severely pissed off by the visible and obvious abusive treatment of her daughter single handedly brought this guy down.  Turned down by the police, ignored by the dental board and refused by lawyers who she sought to hire to stop this behavior, she turned to Facebook and the court of public opinion and then the stuff hit the fan. 

My hat is off to this mom.  She has done more to protect the public than legions of trial lawyers, endless numbers of state and local authorities and every sit-on-their hands dental board in the country.

My hat is also off to John Phillips, a brilliant, aggressive young lawyer who does not tremble at the thought of fighting  mano on mano in the court of public opinion. 
 


​Please watch this 15 minute video (3 segments):​


 


http://crimewatchdaily.com/2016/01/25/pediatric-dentist-accused-of-mistreating-hundreds-of-his-young-patients/


 
Law offices of James R. Moriarty
4119 Montrose, Suite 250
Houston, TX 77006

(713) 528-0700 office
(713) 528-1390 FAX
(713) 857-1212 cell
jim@moriarty.com
moriarty.com

Tuesday, January 12, 2016

Contrasting Dental Medicaid Enforcement: Florida versus Texas


Dr. Michael W. Davis


Contrasting Dental Medicaid Enforcement: Florida versus Texas
By: Michael W. Davis, DDS

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




Introduction
Both Florida and Texas share similarities in that both states have long standing Republican state legislatures, state attorney generals, and state governors. Likewise, both states enjoy highly diverse ethnic and economic population demographics. However, each state handles enforcement of dental Medicaid very differently.

Dental Medicaid fee schedule rates in Texas are some of the highest nationally, while Florida’s are at or near the bottom.1,2,3 Texas has attracted a huge bevy of corporate dental chain Medicaid providers, headquartered both in-state and out-of-state. Florida has a paucity of such interstate dental Medicaid corporate providers.

Although dental Medicaid fee schedule payouts are substantially higher in Texas, both states’ fee schedules fall below the UCR (usual and customary rates) of the average insurance company. With dental Medicaid remunerations below the overhead costs of most private dental practices, only a minority of licensed dentists sign on as Medicaid providers. Those doctors who obtain Medicaid credentialing generally do so to serve a limited number of patients on a charity basis, or work in the public sector. There are some disturbing exceptions.

There are a minority of “outlier” dentists whose goal is to scam the Medicaid program, and make little effort to cover their tracks.4-7 Added to this number are many more devious Medicaid fraudsters, in which only skilled dentist auditors can identify.

Florida dental regulatory authorities have been quicker to turn over cases of suspected Medicaid fraud and abuses to their state’s attorney general’s office. This has occurred far less frequently in Texas, despite Texas being a far more populous state with far greater numbers of dental Medicaid providers.

Extent and Examination of Dental Medicaid Fraud and Abuses
We’ve already learned from the recent limited examination (four states) by federal Health and Human Services- Office of Inspector General (HHS-OIG), that approximately 9-11% of dental Medicaid providers are grossly over-the-top in abusive Medicaid billings.4-7 These specific providers are termed “outliers”. Depending on the state reviewed, one-third to 50% is employed by large group practices (primarily corporate dental chains called “dental support organizations”, “DSOs”). One must remember, these are the worst of the Medicaid program violators, and not the majority with scams designed to “fly under the radar”. Outliers only represent the easy to identify, low hanging fruit.

Typically the cleverer Medicaid fraudsters (non-outlier cheats) upcode Medicaid services or provide gross over-treatment, which isn’t discovered as easily by a HHS-OIG audit.8 One common fraud technique is upcoding of dental sealants on permanent teeth, to multiple surface posterior resin restorations.9 Others place multiple steel crowns on deciduous (baby) teeth, which have minimal to no evidence of dental decay, or are soon to naturally exfoliate (naturally come out).10,11  Another favorite dental Medicaid scam has been the service of a pulpotomy on deciduous teeth (baby tooth root canal), into teeth with little caries (tooth decay) near the tooth’s nerve.12-14 In fact, the author has specifically heard this referenced as a “preventative pulpotomy”, in interviews with former corporate dental employees. Of course, the bitter cynicism and avarice towards the patient’s welfare by this terminology of “preventative pulpotomy” shouldn’t be lost on the dental profession, auditors, or the general public.
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Perhaps unique to Texas, we saw an entrenched old-boy element of the dental profession work to alter and amend standard accepted dental terminology, to expand Medicaid eligibility. Texas Medicaid orthodontics (corrective movement of teeth) eligibility required “ectopically erupted teeth”. Insiders simply changed the Medicaid definition of “ectopically erupted tooth” from the dental industry standard definition, to include any tooth which may be malpositioned, angled, tipped, slightly rotated, etc.15  These schemers circumvented the intent of the law, and lined their pockets either through providing direct Medicaid services or for-profit courses to dentists, on how to beat the system.16

An additional component of Texas dental Medicaid fraud-by-design was Medicaid payments not for completion of an orthodontic case, but for payments on a per-visit basis. Obviously, financial incentive was established to continually yo-yo patients in active treatment, in and out of a dental office. No consideration was afforded to transportation challenges for disadvantaged children. Further, there was a serious disincentive to complete orthodontic treatment in a timely manner, in the patient’s best interest. In the years 2009-2011 Medicaid orthodontic payments in Texas outstripped the payments for all other 49 states combined.17

Texas declined to provide dental Medicaid oversight and monitoring on the state level, and delegated this responsibility (for a significant fee to the taxpayer) to the highly discredited Xerox Corporation.18,19  The federal HHS-OIG agreed with Texas, that Xerox failed in their contractual obligations of dental Medicaid oversight. However, the federal Inspector General stated the State of Texas is ultimately responsible for the disturbingly remiss oversight.20

In fact, services of Xerox were so egregiously lax, that’s it’s difficult to see this as anything other than political pay-to-play. All the while, dental Medicaid fraudsters, both large and small were free to ply their trade in fraud-craft. Texas state authorities provided the illusionary mantle of oversight via a wasteful model of collusion, with big business/big government crony capitalism.

The most common Medicaid unlawful scheme of non-profit dental clinics (federally qualified health centers or FQHCs) is via abuse of “patient encounters”.21 To date, we’ve only see this frequent Medicaid scam addressed by government regulators to much extent in Washington and New York.22,23  This particular abuse of taxpayer money is a favorite with certain public health clinics, Native American title 638 clinics, and non-profit healthcare facilities. Generally we don’t see rank-and-file healthcare providers managing this particular fraud mechanism. Usually fraud is generated though the unlawful systems of directors and managers (some are physicians and dentists), who enjoy very inflated salaries and benefits, by cheating programs designed to serve the disadvantaged.

To its credit in Texas, the non-profit United Medical Centers Board of Directors (Maverick, Kinney, and Val Verde Counties) recently terminated employment of their Chief Executive Officer and Medical Director after an internal investigative audit.24 Unfortunately, I expect another miracle from the waters of Lourdes, before I anticipate Texas authorities to file a civil or criminal case against these Medicaid cheats within the public sector.

One would like to assume nonprofit organizations are distanced from scamming taxpayers. However, that assumption has proven inaccurate and very dangerous. Schemes defrauding the dental Medicaid program are highly pervasive, lucrative, and relatively easy to pull off. Dental Medicaid fraud and abuses are ubiquitous both in the private and public sectors. The largess which comes to those who defraud American taxpayers from dental Medicaid scams has in fact become an entrenched and fully accepted dental industry model of business.  

Handling and Mishandling of Dental Medicaid Cases
Both Texas and Florida have historically operated under a failed enforcement model of “pay and chase”.25,26 Medicaid payments are made to providers (or their corporate beneficial owners, usually DSOs) year after year without question or examination. If an audit is eventually generated, it then becomes a massive records undertaking. Government regulators usually lack funds to retain meaningful dentist auditors, to thoroughly review patient records and billings. Behind the 8-ball, government prosecutors nearly always settle cases for pennies on the dollar, and no admission of wrong-doing by violators.

By contrast, the dental insurance industry mandates pre-authorizations prior to a provider billing for a vast number of patient services. Questionable services and payments are better “nipped in the bud”. Payments are better held in check, not as easily getting out of hand.

Payment holds from the private insurance industry generally are upfront from the onset, on an individual case-by-case basis. By contrast, Medicaid payment holds are usually well down the road, and may represent many hundreds of thousands of dollars or even several million dollars. Medicaid payment holds are formulated by deviations in billings, which are assumed to represent patterns of fraud and abuse. Obviously, a long-term pattern of abusive billings must be established, prior to control of taxpayer (public) monies. Private insurance companies, which have their own set of difficulties, rarely allow fiscal problems to build to this crisis level.


Texas
Dr. Tuan "Terry" Truong
The government’s prosecution of Dr. Tuan “Terry” Truong is a case worth examination.27 Dr. Truong was employed by Kool Smiles Dental in Abilene, Texas, for over a year. After conviction for Medicaid fraud, Dr. Truong was fined and sentenced to federal prison for 18-months. The statement released by Kool Smiles Dental acknowledged their full cooperation with the government’s investigation and prosecution. Yet, Kool Smiles Dental monitors daily production metrics for each of their dentist providers. It seems inconceivable, corporate management didn’t fully realize the inappropriate and unlawful activities of Dr. Truong at a very early stage. Yet, government prosecutors were very willing to accept a low level dentist Medicaid cheat for a guaranteed felony conviction, versus those pulling the strings at higher levels. One is left to wonder what real rats could be convicted, if Dr. Truong were offered a deal to finger corporate management at the DSO level, or even private equity level.

Former Texas Attorney General (today Governor) Greg Abbott gave much ballyhoo to his settlement deal with alleged dental Medicaid fraudster, Dr. Richard Malouf for $1.2 million dollars.28 This settlement only represented pennies on the dollar for the true extent of the alleged fraud (many $10s of millions of dollars). Naturally, there was no admission of wrong-doing by Dr. Malouf, former owner of All Smiles Dental. 

Thursday, January 07, 2016

I found this ad found on Craig’s List; posted January 6, 2016.  My first thought is Reachout Healthcare America until I read the "Non For Profit". 

Thursday, December 10, 2015

The Smile Center–San Antonio Settlement Reached

December 10, 2015 By Patrick Danner

The last of the one-time Smile Center dentists accused in lawsuits of performing “unnecessary” or “excessive” treatments on minors that were then billed to Medicaid have settled the cases. Four dentists this week reached confidential settlements with some 100 patients who had filed medical malpractice claims in Bexar County. “Since 2011, we have filed several lawsuits on behalf of more than 250 children against the Smile Center or former dentists of the Smile Center,” San Antonio attorney Thomas Crosley said. “With this court approval of these last five lawsuits against former Smile Center dentists, we now bring to a close these tragic cases.” He added the cases were settled “to the mutual satisfaction of all parties concerned.” The Smile Center gained notoriety four years ago when WOAI-TV aired a series of stories on the chain of six dental offices. Some of the stories included parents who complained about dental procedures that allegedly left their children in pain.

Read the rest of the story here 

Read one of the Lawsuits here.

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Tuesday, December 01, 2015

Astroturfing by the Dental Support Organization Industry

clip_image002Dr. 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

 

“Astroturfing is the practice of masking the sponsors of a message or organization (e.g., political, advertising, religious or public relations) to make it appear as though it originates from and is supported by grassroots participant(s).”1. -Wikipedia

Introduction
It is imperative the so-called “dental support organization industry” (DSO industry) employ astroturfing techniques, as their entire business model is formulated on gross misrepresentations.2-12 In order to obfuscate the rule of law relating to the unlicensed and unlawful practice of dentistry, these corporate entities must misrepresent themselves as only providing limited nonclinical support services for their chains of dental practices. This is patently false, and has been challenged by numbers of legal rulings and studies. In reality, DSOs either represent the true beneficial owners and clinical management for vast numbers of dental clinics, or they provide management for the private equity beneficial ownership. Doctors only serve in a limited role as façade nominee owners. The word “support” is intentionally designed to deceive. The lies go on.

Forms of DSO Astroturfing
There are four basic designs of astroturfing utilized by the DSO industry. At the most basic level is DSOs placing bogus positive patient reviews with online rating services or their website. The next astroturfing technique involves individual dentists who openly advocate for the DSO industry. The third method employs hired public relations and public advocacy specialists. The final level, and often most challenging to prove, is hired lobbyists who direct public policy through directly influencing government agencies and government elected officials.

Bogus online Patient Reviews
Although this form of deceptive advertising is unlawful, violators are rarely discovered or sanctioned.13 The DSO utilizes existing employees or a retained service to generate positive patient reviews for dental services with online review sites, and/or their own website. Often the specific language utilized in the review is a tip-off, that the bogus reviewer is truly not a clinical dental patient, but working in the dental field.

Certain DSOs have such a disturbingly high degree of employee turnover and negative staff retention rates, they now resort to posting bogus positive reviews of current or former employees on employment websites such as Glassdoor.com and Indeed.com. One will generally see multiple low rated “one-star” reviews, intermixed with over-the-top glowing “five-star” reviews. Obviously, corporate astroturfing is in play.

Individual Dentists Espousing the DSO Agenda
On occasion, state legislatures will take up the cause of regulating and restricting the DSO industry to benefit the public interest. Bills will be presented to establish enhanced transparency in true beneficial clinic ownership. Clarification will be added to protect the doctor/patient relationship (contract), and patient rights such as the informed consent process, and always holding the patient’s interests paramount in clinical decisions. Truth in advertising and lending will be advocated. Mechanisms for bait-and-switch schemes will be discouraged.

Thursday, November 19, 2015

Cleaning up DSO's is Essential to Increasing Access to Dental Care for Low-Income Children

“…For most Americans, going to the dentist isn't at the top of the list of things we want to do, but we go anyway, because dental care is necessary for our health and well-being. However, many of the poorest children in America don't have the luxury of dreading a trip to the dentist.

According to the Centers for Medicare and Medicaid Services (CMS), 43 million children in the U.S., including half of all low-income children, receive health coverage through Medicaid. This coverage includes dental services as part of the Early and Periodic Screening, Diagnostic, and Treatment benefit.

“…While the DSO model has been successful, there remain areas of concern. A 2012 joint investigation by PBS's Frontline and the Center for Public Integrity (CPI) uncovered the questionable practices of some DSO's that raise red flags with state Medicaid officials.

The piece did, however, hold up one particular DSO as an ideal model that is "showing hope." Sarrell Dental, a nonprofit dental practice with 17 locations throughout Alabama, received a glowing review. However, some unsettling changes have occurred at Sarrell Dental since that Frontline broadcast.

In 2013, Sarrell Dental was acquired by Massachusetts-based DentaQuest. DentaQuest's President of Care delivery is Todd Cruse, who previously ran a company called FORBA Holdings LLC, a dental management company that provides business management and administrative services to 69 clinics nationwide known as "Small Smiles Centers."

Read the entire piece at Huffington Post

 

Wednesday, November 18, 2015

Arizona’s Dental Dangers: Reports by ABC15 News Phoenix

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

 

Arizona’s Dental Dangers: Reports by ABC15 News Phoenix
By Michael Davis, DDS

This year investigative reporters, Dave Biscobing and Shawn Martin presented a series of very insightful reports for ABC15 News out of Phoenix, AZ. These investigative journalists openly challenged policies of the Arizona State Board of Dental Examiners (ASBDE). They took their investigations directly to the state legislature and governor. In our modern era of diminished resources for investigative journalism in the media, these local media market reporters exemplify the highest standards for service to their profession and the public interest.

The entire series of “Dental Dangers” stories can be accessed via this link:

http://www.abc15.com/dentaldangers

Mrs. Biscobing and Martin have detailed problems as diverse as the protective “old boy’s club” for deviant dentists, within the state dental regulatory board. They exposed the dental board’s failure to disclose public record material on dentist violators. Their report on unlicensed and unregulated dental laboratories was also disturbingly informative. Patients and doctors may have no idea from what nation, and under what safeguards, their dental prosthetics may be fabricated. In fact, ABC15 uncovered that Arizona failed to provide criminal background checks for newly licensed dentists.

This reporting goes far beyond the interests of Arizona. It has significant merit nationally. Dental dangers to the public welfare can be found in most states. Our dental public regulatory agencies, which are supposed to serve the public interest, are often primarily serving a variety of other interests. This investigative reporting did in fact stimulate the process for positive changes to the operation of the ASBDE, although much more is required.

The courageous reporting of Mrs. Biscobing and Martin exposed elements within the state legislature and governor’s office, which discounted the public interest. That unfortunate fact came forth loud and clear. We witness a form of journalistic integrity, which is too infrequently seen on the national media stage, let alone a local media outlet.

We all owe a tip of the hat to Dave Biscobing, Shawn Martin, and the entire crew at ABC15 News in Phoenix. I encourage Dentist the Menace readers to click on the above link, and enjoy an inspired series of reports on dental investigative journalism.

Tuesday, November 17, 2015

Dental Assistant of Howard S. Schneider, LaTosha Bevel-Hillsman Arrested

imageFlorida’s attorney general’s Medicaid Fraud Control Unit and the Jacksonville Sheriff’s Office have issued another warrant in the medicaid / abuse criminal case related to Jacksonville dentist Howard S. Schneider. Schneider was arrested yesterday. Read more about that here. They arrested and booked his assistant LaTosha Bevel-Hillsman on charges of practicing dentistry without a license, defrauding the Florida Medicaid program and child abuse. Hillsman was booked into the Duval County jail just after 5 p.m. Tuesday, November 17, 2015. What has been identified as her facebook page has very risque (and unhygienic) photos. Her license cannot be found on the State’s license verification as her name doesn’t match.

According to the JSO Inmate Information Search, Bevel-Hillsman is being held on a $30,009 bond. She is not yet scheduled for a court date. It is unknown if the practice will be providing her with a criminal defense lawyer.

Here is her booking report:

Howard Schneider and Latosha Bevel-Hillsman Mugshots

Warrant Issued for LaTosha Bevel-Hillsman, Dental Assistant of Dr. Howard S Schneider

JACKSONVILLE, Fla. —

    The Jacksonville Sheriff’s Office has issued a warrant for one of Dr. Howard Schneider’s former dental assistants.

    LaTosha Bevel-Hillsman is accused of practicing dentistry without a license, defrauding the Florida Medicaid program and child abuse.

    Bevel-Hillsman is facing a child abuse charge and the state says she practiced dentistry without a license at Schneider's former office. The state also said she defrauded the Medicaid program while she worked at the office.

    The embattled pediatric dentist Schneider was arrested Monday for Medicaid fraud by submitting claims for dental procedures he performed without parental consent. 

    - See more at: http://www.actionnewsjax.com/news/news/local/schneiders-former-dental-assistant-accused-practic/npPjK/#sthash.Hwi9N95M.dpuf


    Duval County Pediatric Dentist Arrested for Medicaid Fraud

    TALLAHASSEE, Fla.—Attorney General Pam Bondi’s Medicaid Fraud Control Unit and the Jacksonville Sheriff’s Office today announced the arrest of former pediatric dentist, Dr. Howard S. Schneider, 78, for defrauding the Florida Medicaid program.

    The MFCU’s investigation revealed that Schneider, the sole owner of Howard S. Schneider, D.D.S. P.A., defrauded Florida Medicaid by submitting claims for dental procedures he performed without parental consent. The procedures allegedly fell below the standard of care and produced unauthorized claims submitted to the Medicaid program for reimbursement.

    In conjunction with Schneider’s arrest, the MFCU and the Jacksonville Sheriff’s Office have an active arrest warrant for one of Schneider’s former dental assistants, LaTosha Bevel-Hillsman, for practicing dentistry without a license, defrauding the Florida Medicaid program and child abuse. Hillsman, 39, allegedly performed an extraction on a pediatric patient; a procedure that Hillsman is not authorized to perform. The investigation revealed that this procedure caused harm to the child and produced unauthorized claims submitted to the Medicaid program for reimbursement.

    Schneider faces 11 counts of Medicaid provider fraud of $10,000 or less, a third degree felony. If convicted, Schneider faces up to 55 years in prison and more than $825,000 in fines and restitution.

    The State Attorney’s Office for the Fourth Judicial Circuit will prosecute this case. Hillsman faces one count of practicing dentistry without a license, one count of Medicaid provider fraud of $10,000 or less, and one count of child abuse, all third degree felonies. If convicted, Hillsman faces up to 15 years in prison and more than $15,000 in fines and restitution.

     

     

    Mugshot of LaTosha Bevel-Hillsman from a previous arrestLaTosha Bevel-Hillsman Mugshot for writing bad checks

     

     

     

     

    Howard S Schneider Mugshot

    Mugshot of Howard S. Schneider Nov 2015 arrest

    Monday, November 16, 2015

    Dr. Howard S. Schneider Arrested for 11 Counts Medicaid Fraud

    Nov. 16, 2015

    Dr. Howard S. Schneider of Jacksonville, Florida has been arrested this afternoon.

    Pediatric dentist accused by a group of parents of hurting children, was arrested Monday.
    According to the Jacksonville Sheriff's Office Inmate Information Search, Schneider was arrested on 11 counts of unauthorized Medicaid claims.
    Schneider turned himself into to JSO around 4 p.m. Monday, according to the office of Attorney General Pam Bondi.

    His total bond is listed at $110,033, according to JSO's Inmate Information Search. Schneider does not have a court date scheduled at this time.

    - See more at: http://www.actionnewsjax.com/news/news/local/dr-howard-s-schneider-arrested-medicaid-fraud-char/npPGs/#sthash.5rQ156kR.dpuf

    On November 13, 2015, Schneider filed for an emergency distribution of marital funds in anticipation of his arrest.

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    Charges:

    Howard Schneider Charges.pdf by Dentist The Menace

    Business Service Agreements: A Tool for Deception within the Corporate Dental Support Industry

    Business Service Agreements: A Tool for Deception within the Corporate Dental Support Industry

    Dr. Michael DavisBy Michael W. Davis, DDS

    Business Service Agreements (BSAs), also called Business Service Contracts or Management Service Agreements (MSAs), are a tool created by the dental support industry (a/k/a dental support organizations) to mask their true business operational models. These contracts are generated between the unlicensed ownership (corporate beneficial owner) and the sham figurehead owner (nominee owner dentist(s)).

    These agreements contain a variety of misrepresentations specifically designed to circumvent the rule of law. These BSAs serve as a lynchpin supporting the unlawful house of cards, of largely unlicensed and unregulated healthcare entities. Please note: the term “dental support organization” is also an intentional misrepresentation, to mask beneficial ownership.

    Case precedent was established in federal Fifth Circuit ruling 07-30430)1., in which the court determined a Dental Support (Service) Organization (DSO), Orthodontic Centers of America (beneficial owner of dental clinics), was engaged in the unlicensed and unlawful practice of dentistry. The court also ruled the business agreements with so-called “owner” dentists were unenforceable and non-severable (denying one part could be enforced while another could not), because elements in these contracts were unlawful, the entire contract was rendered unenforceable.

    Nationally, every DSO has created different BSAs. And, within different states, different DSOs will produce different agreements. However, there exist common features worth examination in the vast majority of these contracts.

    Dental Clinic Ownership

    The DSO generally will deny ownership of the dental practice. Yet, the DSO usually owns the facility or is the landlord on the lease agreement. The DSO owns the dental equipment, supplies, and any possible leasehold improvements.

    The DSO enjoys contract rights to control what dentists or entity may be artificially designated as “owners”. An owner dentist(s) may not freely sell “their” asset of a dental practice, and thus are merely façade nominee owners. The DSO controls the bank accounts of the “owners’” clinic bank accounts, which are swept out several times per week, or daily. These are central points in the lawsuit against Dental One Partners, DentalWorks, et al, by 14 duly licensed North Carolina dentists enjoined by the North Carolina Board of Dental Examiners, in 2013.2.

    Thursday, November 12, 2015

    Ben Carson Wants Jail Time For Health Care Fraud -- Except For Dentist Friend

    Huffpost

    "We became friends about a decade ago because we discovered that we were so much alike and shared the same values and principles that govern our lives."

     

    "…Pittsburgh dentist Alfonso A. Costa pleaded guilty to a felony count of health care fraud after an FBI probe into his oral surgery practice found he had charged for procedures he never performed, according to court records."

    "At Costa's 2008 sentencing hearing, Carson described the dentist as "one my closest, if not my very closest friend...”

    "We became friends about a decade ago because we discovered that we were so much alike and shared the same values and principles that govern our lives," Carson told the judge, adding that their families vacationed together and that they were involved in "joint projects."

    "Next to my wife of 32 years, there is no one on this planet that I trust more than Al Costa," Carson said."

    Read The Entire Story Here

    Wednesday, November 11, 2015

    AOL Accuses Dr. Richard Malouf of Gaming The Texas Judicial System

    DTM Avatar 140517Everyone remember the Texas dentist, Dr. Richard Malouf, who sued nearly everyone in sight that had the gall to report or offer comment on the “House That Medicaid Built”?  The place got so big he had to purchase the house next door and he installed his own personal waterpark; dubbed here as 6 Flags Over Malouf.


    malouf3











    The story won investigative reporter Byron Harris and WFAA a 2013 Edward R. Murror Award:
    water-park1Screen-shot-2012-04-21-at-7.00.24-PMWFAA won a 2013 Edward R. Murrow Award for its investigation of Texas Medicaid fraud, including the allegation that Malouf used taxpayer money to build his personal waterpark. Texas law generally prohibits the seizure of one's home, even in the event of wrongdoing, but there is a loophole.
    "If that home is purchased with stolen money, or that home is purchased based on money that has been earned by falsehood or deceit, then that home is not protected at all," attorney Jim Moriarity told WFAA.
    Malouf sued a long list of folks, including actor Owen Wilson’s mom, who lived next door, for trespassing, invasion of privacy, and defamation which included America Online (AOL) for publishing the story.
    Apparently Malouf , and his wife LeAnne find themselves in the 11th hour of trial without legal representation in his defamation suit which continues with AOL, Graham Wood and Candace Evans
    AOL is basically calling “bullshit”, saying Richard and Leanne Malouf have a pool of a dozen or more attorney’s across Texas and should not need 4 months to hire another one.
    I agree!
    This is a must read! Enjoy!

    PS. That is not the only system Mr. and Mrs. Richard Malouf gamed.  Just saying.

    Malouf v AOL_Wood - Response to Motion for Continuance