Monday, April 26, 2010

FORBA Small Smiles Employees CIA Compliance Is Up To You; Includes Warning To Future Employees

ATTN:  All FORBA Small Smiles Employees
ATTN: Potential Employees: This is a must read before you agree to be employed by FORBA or any of its Small Smile clinics.  Full disclosure is a must!

FORBA has entered into a Corporate Integrity Agreement (CIA) with the Office Of Inspector General (OIG) after being caught red handed committing fraud and mistreating children.  (not only red handed but on video!)

Of course FORBA admitted no wrong doing as they will be quick to tell you.  However, anyone who would rather pay $24 million dollars plus interest and sign a 67 page set of rules to follow for the next 5 years, is probably guilty in my opinion.

[I would say FORBA was probably thinking this was a deal compared to what might happen if they didn’t agree and further delving into FORBA’s setup would likely reveal much worse things happening, that’s a scary thought isn’t it?]

When push comes to shove, it’s you, the employee on the front lines to see that the provisions in the CIA are followed.  I would highly recommend you download and take time to read the rules since you are the main one playing the game.  It’s your butt out there.  You may not have signed it, but you are as legally bound by this agreement as if...
you had signed it in your own blood.

In the CIA Section II(C)(1)(b)on page two it will tell you that “Covered Persons” includes: all owners, officers, directors and employees of FORBA facilities, (c) all contractors, subcontractors, agents and other persons who perform patient care duties, make assessments of patients and perform billing, coding and the list goes on.  Actually it pretty much covers anyone or any company who works for FORBA in any way for more than 160 hours during a calendar year.

If the rules are not being followed who do you think FORBA will quickly throw under the bus?  Yes, you.  I don’t see the corporate heads stepping up and taking the blame, do you?  They’ve not done that so far and the best predictor of future behavior is past behavior.

I admit people do change, but in this case it’s not likely.  Remember FORBA has known it’s been under investigation since 2007 and we see how things have been run during that time.  To this day they admit no wrong doing as is clear in their statement after the news broke about the $24 million dollar settlement.

Every day companies enter into CIA’s and fail to follow the rules of compliance. In some cases they dig themselves a bigger hole trying to cover up the cover up of the False Claims Act (FCA). Attorney’s and compliance officers for corporations end up in deep doo doo more than you might think.

It will serve you well to read the US. v. Christi Sulzbach analysis - click here.  I can’t stress enough that even though FORBA Holding’s Michael Lindley, Alfred (Al) Smith and others signed the CIA, it’s you, the Small Smiles and FORBA Holding employee, who must bare the burden of satisfying the OIG ‘s acceptable standards set out in the CIA.

To the attorneys and CCO Allison Luke,“When general counsels and Chief Compliance Officer’s (CCO) attest to any fact or statement on behalf of the company in a government filing, if that fact isn’t true, they become an easy target. Their signature is essentially a one-way ticket to criminal prosecution or civil liability,” said Michael Gurland, a former federal prosecutor when speaking about the Christi Sulzbach case.

If you have not been encouraged by FORBA to read the CIA, that in itself is concerning.  It’s something every person who currently works for FORBA and ANY of it’s affiliates, subsidiaries, any legal entity FORBA operates or with whom FORBA has a contract or arrangement with during the term of the CIA should certainly read.

The CIA also includes anyone who joins FORBA (e.g. dentists, dental assistants, office managers, hygienist, regional managers, office staff, patient advocate).  So besides the contract FORBA will ask you to sign, pretty much promising them your first, second and third born children, you need to know you must abide by the CIA.

FORBA should disclose this to any new employees in my opinion.  I certainly would want to know I was under the microscope before I took any position with this or any company.

[In the actual Department of Justice Settlement, FORBA is to ‘encourage’ cooperation of its current and former agents, directors, officers and employees to hand over everything and tell all you know as the Department of Justice continues its investigation]

With hundreds of millions at stake for FORBA/Small Smiles and its capital investors, including Arcapita,  it would be a very good idea to cya everything you report or see.  If it were me, I would have a backup of everything I reported to whom ever I reported.  I would have a copy of it, a picture of it, and keep a detailed journal of it.  Myself, I wouldn’t make any complaint or report via phone unless it’s a recorded conversation.  (FYI, some states require both parties be made aware if a phone call is recorded, some require just one and some none at all, check your state laws on this)

No doubt the CIA over rules the FORBA/Small Smiles manual.  I bring all of this up because its important for everyone to know where you’re at, where the company is, and where it needs to go and if its headed in the right direction.

I feel it’s important for you to know that if FORBA operates any new clinics over or above its projected growth, they will have to pay an additional $500,000.00 for each year in which it exceeds projections.  Or maybe you need to know that one slip up and FORBA could be shut completely out of any and all Federal heath care programs.

Maybe you need to know FORBA has agreed to set up an Independent Review Organization and Compliance Committee and to have an independent monitor to “perform the monitoring functions described in Section III of the CIA.”

You certainly need to know a Compliance Committee must be established by late April, 2010 and at least seven Compliance Liaisons put in place on a rotating basis to participate in each committee meeting, which are to be held monthly.  I would  also want to know that the Compliance Liaisons are to be someone at each facility and “shall” be either the Lead Dentist or the Office Manager.

[The two people in each office who are the worst offenders!!  OMG!] 

I would especially want to know if I were a dentist thinking about signing on with FORBA Small Smiles, since that is the big complaint; how horrible the leads are and having to practice dentistry according to what some unskilled office manger tells you.  This clearly indicates the power of the office manager.

You also need to know what is at stake and know how easy it will be for FORBA to do what it can to NOT live up to the agreement and CIA.  They are supposed to notify the OIG 30 days ahead of time if they want to sell a chair.

The whole set up of the Compliance Committee is destined to fail, everyone on the committee has a huge interest of keeping every wrong doing covered up.  In fact I couldn’t design a more perfect committee to continue their disgusting behavior.  Think about it.

[ I suppose they are going to let Bernie Madoff out to audit the books too?]

For sure, Dr. Steve Adair is going to have to get off the stool and actually do something.  He’s under a lot of pressure to clean this mess up.  No more sending out memos and getting a paycheck.  No more lending his name and face as the poster child.  Dr. Adair is required to actually work and NOT answer to FORBA’s attorneys or CEO.  He’s supposed to do audit on a monthly basis.  (yeah, like that’s gonna happen, right now they tell him what to do and when to do it)

Information is power, and knowing whether FORBA is living up to its obligations will tell you when or if you need to be looking for another job.  Personally, I would already be looking.

At this point the OIG should have appointed a monitoring team - it was to be in place within 90 days of the agreement being signed. I think you need to know the name and contact information of the head monitor in charge in case the need arises. But of course, that’s just me. Like that complaint last week, who knows if it was thrown in the trash or sent on to the monitor.

Of course this is where I come in.  FORBA is not going to know what I know, who has told me, and to whom I forwarded that information now will they. Basically I've been the monitor and patient advocate for 2 plus years, and don't plan on leaving my post any time soon.

There should also be an Independent Review Organization (IRO) in place by now.  It was to be in place within 90 days of the agreement.  Anyway, there is much I think you need to know.  How are you going to know what you don’t know, if you don’t take time to know it.

One last thing for today, in the settlement, it is mentioned that FORBA will be reorganizing its structure-Section III (18). You’ll find that on page 16 of the “settlement agreement". I would seriously like a little look see at the Exhibit F mentioned.  If anyone has it I would really appreciate it if you sent it to me, my email in in the right hand column.

Please don’t consider this anything close to legal advice. It’s purely FYI, CYA and how I see it.