Fort Wayne Indiana Follow up Story

August 4, 2009

Dan Stockman of Fort Wayne's Journal Gazette has a followup story after his initial story on Kool Smiles.

http://www.journalgazette.net/article/20090804/EDIT07/308049997/1021/EDIT

A growing list of complaints against Kool Smiles, a chain of dental clinics that targets children covered by Medicaid and Hoosier Healthwise, should prompt an investigation by state officials charged with oversight of business and medical services. It also raises questions about the environment of consumer protections in Indiana.

In a report published Sunday, The Journal Gazette’s Dan Stockman detailed complaints leveled by Fort Wayne parents who have taken children to the Bluffton Road clinic. The complaints included stories of distraught children restrained by employees for treatment, parents barred from the treatment rooms while their children were undergoing treatment and of unnecessary dental procedures.

Stockman’s investigation found that the limited-liability corporation that operates Kool Smiles here and at five other Indiana clinics has not paid its yearly business licensing fees in two years. Its authorization to do business was revoked by the Indiana secretary of state’s office in February, but the clinics continue to operate.

State Rep. Phil GiaQuinta, D-Fort Wayne, said Monday he had heard at least one complaint of unnecessary dental work recommended by the clinic. He acknowledged that the claims raised in the article should be pursued. “More questions need to be asked,” GiaQuinta said. “I haven’t looked into it, but I do think more needs to be known.”

The state of Georgia, where Kool Smiles first opened in 2002, revoked its authority to do Medicaid work two years ago after an audit by the Georgia Department of Community Health inspector general found multiple improper practices, including a “large number” of tooth restorations done on patients without anesthesia and large amounts of anesthesia given to patients below the recommended weight level.

WellCare Health Plans, the company that operates Georgia’s Medicaid program, dropped Kool Smiles as a provider at 18 locations. The company settled with the state in January 2008 for $193,508.

The charges against Kool Smiles extend beyond both Georgia and Indiana. The company operates 84 clinics nationwide and is actively recruiting for dentists, hygienists and other employees at clinics across the country. A television station in Newport News, Va., reported in November on cases where parents sought second opinions on dental care recommended for their children and learned that no treatment was needed.

Medicaid, a shared responsibility of the federal government and state government, reimbursed Kool Smiles for $11.1 million last year, almost 7 percent of all Medicaid and Hoosier Healthwise reimbursements made in the state. Indiana officials told The Journal Gazette that they have received no complaints about the six dental clinics in the state, but the state’s procedures for filing a complaint are difficult.

The Indiana Professional Licensing Agency is the one responsible for fielding complaints. Its mission statement clearly indicates it is oriented to serving professionals, not consumers. Harried parents, particularly those who must depend on state assistance for medical and dental services for their children, do not have the time and patience to unravel more bureaucracy to level a complaint with the appropriate agency.

The secretary of state’s office also has a responsibility to ensure its own licensing practices are enforced, and the attorney general’s office should have a better handle on widespread consumer complaints leveled against a company doing business in Indiana.

Hoosiers need to know that their interests as consumers and taxpayers are being as zealously protected as those of Indiana business owners.